Association between saddle nose deformity and retro-orbital mass in Wegener's granulomatosis.
OBJECTIVE
The relationship between saddle nose deformity (SND) in Wegener's granulomatosis (WG) and other clinical features, including retro-orbital mass formation (ROM), has been poor described. Therefore, this relationship was analyzed retrospectively from 2000 to 2010.


METHODS
Eighteen consecutive WG patients with SND diagnosed by computed tomography were matched to 36 WG patients without SND (control group) for gender, age at WG diagnosis and disease duration.


RESULTS
No difference was found between the two groups in relation to WG type (limited and systemic forms), ethnicity, laboratory features, constitutional symptoms or clinical manifestations, including upper respiratory tract, and treatment, except for ROM (33.3 vs. 2.8% in SND(+) and SND(-) groups, respectively; p=0.004) and subglottic stenosis (22.2 vs. 2.8%; p=0.038). However, on multivariate analysis, only ROM (OR 17.15; 95% CI 1.11-265.52) was statistically associated to SND. In addition, in more than half of the cases, SND manifested prior to ROM.


CONCLUSIONS
Results of this prospective analysis showed that SND was strongly associated to ROM in WG. Since early diagnosis and aggressive treatment of orbital involvement could lead to better prognosis, the presence of SND warrants additional vigilance.
Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil.
Guilherme Laranja
GL
Gomes
Ari Stiel
AS
Halpern
Fernando Henrique Carlos de
FH
Souza
Samuel Katsuyuki
SK
Shinjo
D000328:Adult; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D009667:Nose Deformities, Acquired / Q000209:etiology*; D009916:Orbital Diseases / Q000209:etiology*; D012189:Retrospective Studies