title: Granulomatosis with polyangiitis: the relationship between ocular and nasal disease.
abstract: OBJECTIVE
  To analyze the relationship between ocular manifestations and nasal pathology.
  
  
  METHODS
  A retrospective study of 19 granulomatosis with polyangiitis (GPA) patients with ophthalmic and nasal manifestations.
  
  
  RESULTS
  Ten cases exhibited changes in orbital structure accompanied by changes in paranasal sinuses, 2 cases had chronic dacryocystisis, and 1 case had nasolacrimal canal stenosis. Among the 17 cases that were finally diagnosed by biopsy, 12 cases were diagnosed by nasal mucosa biopsy. Sixteen GPA cases were diagnosed by CT or MRI. Nasal involvement alone or with orbital involvement was detected in 14 cases. All cases were misdiagnosed for 2-36 months.
  
  
  CONCLUSIONS
  Granulomatosis with polyangiitis with ocular and upper respiratory diseases as the first symptom is easily misdiagnosed. Patients with ocular and upper respiratory diseases should be given a laboratory ANCA test, nasal mucosa biopsy, and imaging of the orbit, nasal cavity, and paranasal sinuses to establish early diagnosis of GPA.
authors.affiliation: Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Jiang
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Zhao
authors.forename: Shi-hui
authors.initials: SH
authors.lastname: Wei
mesh_terms: D000328:Adult; D001706:Biopsy; D002681:China / Q000453:epidemiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology; D009668:Nose Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D056647:Systemic Vasculitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult