[Clinical analysis of 17 cases of anti-neutrophil cytoplasmic antibody associated vasculitis combined with chronic rhinosinusitis].

Objective: To analyse the clinical characteristics of patients of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) combined with chronic rhinosinusitis (CRS) and its diagnostic strategy. Methods: A retrospective analysis of 228 patients with AAV treated in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from August 2008 to June 2018 was performed. Among them, 17 (7.5%, 17/228) patients(10 males and 7 females, with the range of age from 17 to 67 years old) had CRS and their clinical manifestations, laboratory examinations, treatment and prognosis were summarized and studied. Results: In addition to nasal obstruction and increased nasal secretion, 17 AAV patients with CRS were accompanied by cough, wheezing and other pulmonary symptoms (5/17), fever (7/17) and anemia (7/17). Laboratoy tests showed positive ANCA (14/17), increased C-reactive protein (9/17), haematuria (8/17) and proteinuria (6/17). Except for 2 patients who went to other hospital, most patients (14/15) were relieved by glucocorticoid and immunosuppressive therapy. Conclusions: AAV patients with CRS may be accompanied by systemic and pulmonary symptoms (cough, asthma, fever, anemia, etc) or some positive laboratory tests (elevated C-reactive protein, proteinuria and/or hematuria, etc.). To achieve the goal of early diagnosis of AAV, ANCA test and biopsy are recommended for those patients with AAV and CRS concurrently.