J Audiol Otol.  2023 Jul;27(3):161-167. 10.7874/jao.2022.00311.

A Case of Unilateral Otologic Symptoms as Initial Manifestations of Granulomatosis With Polyangiitis

Affiliations
  • 1Department of Otorhinolaryngology with Head and Neck Surgery, University Hospital Center Split, Split, Croatia
  • 2Department of Pathology, Forensic Medicine and Cytology, University Hospital Center Split, Split, Croatia

Abstract

Granulomatosis with polyangiitis (GPA) is a chronic and systematic autoimmune condition characterized by granuloma formation and necrotizing vasculitis of small to medium-sized vessels. GPA initially presents itself as respiratory and renal symptoms. Although temporal bone involvement is not uncommon, an otologic disorder is rarely the initial symptom. We present a case of a 36-year-old man who presented with unilateral ear pain, hearing loss, and facial palsy. After a series of diagnostics and temporal bone and chest imaging, he was diagnosed with GPA with multiorgan involvement. Cyclophosphamide and methylprednisolone relieved the patient’s ear pain and partially improved his hearing, facial palsy, and overall clinical condition. Although uncommon, systemic GPA may cause initial otologic symptoms and should not be dismissed as a possible cause of an otologic disease resistant to standard therapy.

Keyword

Granulomatosis with polyangiitis; Facial palsy; Hearing loss; Otalgia
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