title: Toothache and hearing loss: early symptoms of granulomatosis with polyangiitis (GPA).
abstract: Granulomatosis with polyangiitis is an uncommon condition characterised by vasculitis and associated granuloma formation with a highly specific autoantibody, namely proteinase 3-anti-neutrophil cytoplasmic antibody (ANCA). The respiratory tract and kidneys are the organ systems most often involved. Symptoms can be non-specific, and isolated hearing loss can predate other symptoms by months, leading to lengthy delays in diagnosis and treatment. Left untreated, hearing loss can be irreversible, and therefore early diagnosis is crucial. We present a case study of severe hearing impairment in an attempt to raise awareness of ear involvement as an early feature of this unusual condition.
authors.affiliation: Department of Clinical Medicine, Trinity College Dublin Faculty of Health Sciences, Dublin 8, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Brown
authors.affiliation: Department of Immunology, St. James's Hospital, Dublin 8, Ireland.
authors.forename: Niall
authors.initials: N
authors.lastname: Conlon
authors.affiliation: Department of Immunology, St. James's Hospital, Dublin 8, Ireland.
authors.forename: Conleth
authors.identifier: http://orcid.org/0000-0002-7283-2303
authors.initials: C
authors.lastname: Feighery
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D034381:Hearing Loss / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D014098:Toothache / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D004164:Diphosphonates; D054328:Proton Pump Inhibitors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003520:Cyclophosphamide; D011239:Prednisolone; D001379:Azathioprine