title: Pulmonary manifestations of granulomatosis with polyangiitis.
abstract: OBJECTIVE
  To describe the clinical and laboratory data, with special emphasis on thoracic imaging findings, in 14 patients with a definitive diagnosis of granulomatosis with polyangiitis (GPA).
  
  
  METHODS
  The clinical and tomographic data of 14 patients with a definitive diagnosis of GPA are presented. Patients with thoracic manifestations suggestive of GPA were evaluated in 3 hospitals from 2000 to 2012. All patients had a sputum analysis and bronchoalveolar lavage for bacterial, mycobacterial and fungal stains and cultures; antineutrophil cytoplasmic antibodies, antinuclear-antibodies, rheumatoid factor, and a biopsy of involved organs.
  
  
  RESULTS
  A total of 13 patients had at least two organs involved. The most frequent thoracic findings were pulmonary nodules, ground glass opacities and patches of consolidation; other abnormalities were tracheal stenosis, diffuse alveolar hemorrhage, lung masses with organized pneumonia. More than three-quarters (78%) of patients had positive antineutrophil cytoplasmic antibodies (ANCA). Ten patients had respiratory tissue biopsy (8 open lung, one tracheal, and one nasal). In 4 patients the diagnosis was made with the classic organ involvement in GPA, positive ANCA, and renal or skin biopsy, and response to treatment on follow-up. At 6-12 months all patients showed clinical and radiological improvement, with 54% showing a recurrence of disease.
  
  
  CONCLUSIONS
  The majority of thoracic findings described in GPA are presented in this study. A complete diagnostic approach with invasive diagnostic procedures to rule out other more prevalent respiratory diseases with similar thoracic manifestations must be performed. The positivity of ANCA in this study was high, and the recurrence of the disease was frequent.
authors: Servicio de Neumología, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México; Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
authors: Alejandro
authors: A
authors: Gómez-Gómez
authors: Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Servicio de Reumatología, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México.
authors: Marco Ulises
authors: MU
authors: Martínez-Martínez
authors: Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Servicio de Reumatología, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México.
authors: Enrique
authors: E
authors: Cuevas-Orta
authors: Servicio de Neumología, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México.
authors: Juan Mario
authors: JM
authors: Bernal-Blanco
authors: Servicio de Neumología, Hospital General de Zona N.(o) 2, Instituto Mexicano del Seguro Social, San Luis Potosí, México.
authors: Daniel
authors: D
authors: Cervantes-Ramírez
authors: Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Servicio de Radiología y Radiología Intervencionista, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México.
authors: Raúl
authors: R
authors: Martínez-Martínez
authors: Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Servicio de Reumatología, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México. Electronic address: c_abud@hotmail.com.
authors: Carlos
authors: C
authors: Abud-Mendoza
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic
keywords: Afección pulmonar; Granulomatosis con poliangeítis; Granulomatosis de Wegener; Granulomatosis with polyangiitis; Granulomatous polyangiitis; Lung nodules; Nódulos pulmonares; Poliangeítis granulomatosa; Pulmonary involvement; Pulmonary vasculitis; Vasculitis pulmonar; Wegener granulomatosis