title: [Otomastoiditis as an initial clinical manifestation of Wegener's granulomatosis].
abstract: Wegener's granulomatosis (WG) forms part of a group of primary vasculitis of the small and medium-sized blood vessels, associated with antineutrophil cytoplasmic antibodies (ANCA). This disease may affect any body organ, especially the upper and lower airways and the kidneys. Hardly ever is otomastoiditis the first and only clinical manifestation of generalized Wegener's granulomatosis. We present the case of a patient whose disease started with the inflammation of the middle ear, which was unresponsive to the usual treatment. Later he developed nasal, pulmonary and renal compromise. The determination of ANCA and a transbronchial biopsy confirmed the diagnosis of WG. We report this case to express the view that otomastoiditis in adults, which is refractory to the usual treatment, may seldom be the first and only clinical manifestation of WG.
authors.affiliation: Servicio de Clínica Médica, Sanatorio Otamendi Miroli, Buenos Aires.
authors.forename: Jorge
authors.initials: J
authors.lastname: De All
authors.forename: Gabriel
authors.initials: G
authors.lastname: Koutnouyan
authors.forename: Sergio
authors.initials: S
authors.lastname: Herrando
authors.forename: Eduardo
authors.initials: E
authors.lastname: Diez
authors.forename: Gloria
authors.initials: G
authors.lastname: Olmedo
authors.forename: Cesar
authors.initials: C
authors.lastname: Gnocchi
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D008417:Mastoiditis / Q000209:etiology*; D008875:Middle Aged
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic