title: A diagnostic dilemma: differentiating between granulomatosis with polyangiitis and tuberculosis.
abstract: Granulomatosis with polyangiitis (GPA, formerly Wegener's granulomatosis) can present diagnostic difficulties for the clinician as there can be considerable overlap in features with tuberculosis (TB). Indeed, there are documented cases both of coexisting TB and GPA, and cases wrongly diagnosed as GPA when in fact TB was the underlying diagnosis. This lesson presents a case of GPA where TB was also considered as a differential and highlights the diagnostic and management difficulties when this is the case.
authors.affiliation: North Devon District Hospital, Barnstaple, UK. farrouqmahmood@doctors.org.uk
authors.forename: Farrouq S
authors.initials: FS
authors.lastname: Mahmood
authors.forename: Edward
authors.initials: E
authors.lastname: Schwatz
authors.forename: Shinoy
authors.initials: S
authors.lastname: Kurrup
authors.forename: Charles
authors.initials: C
authors.lastname: Sharp
authors.forename: Georgina
authors.initials: G
authors.lastname: Hands
authors.forename: Alison
authors.initials: A
authors.lastname: Moody
mesh_terms: D001706:Biopsy; D003937:Diagnosis, Differential; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D055953:Microscopic Polyangiitis / Q000150:complications / Q000175:diagnosis*; D009297:Nasal Mucosa / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis*; D055815:Young Adult
references.citation: Med Clin North Am. 1993 Nov;77(6):1235-51
references.pmid: 8231409
references.citation: Indian J Med Sci. 2004 Jul;58(7):283-8
references.pmid: 15286419
references.citation: Rheumatology (Oxford). 2003 Feb;42(2):223-9
references.pmid: 12595614
references.citation: Thorax. 1986 Mar;41(3):219-20
references.pmid: 3715781
references.citation: Br J Rheumatol. 1993 Feb;32(2):143-9
references.pmid: 8428228
references.citation: JAMA. 1987 Aug 14;258(6):809-11
references.pmid: 3613009