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Granulomatosis With Polyangiitis (Gpa) in a 15-Year-Old Girl With Facial Acne-Like Ulcers: A Case Report Publisher Pubmed



Moghadam SRJ1 ; Salehi MR2 ; Mojtahedi SY3 ; Fadaei N4 ; Dadras O5 ; Seyedalinaghi S5 ; Mohammadifirouzeh M6
Authors
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Authors Affiliations
  1. 1. Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Infectious Diseases and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Family Medicine, Medicine Faculty, Tehran University of Medical Sci-ences, Tehran, Iran
  5. 5. Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. School of Nursing, George Mason University, 4400, University, 22030, VA, United States

Source: Infectious Disorders - Drug Targets Published:2020


Abstract

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a multisystem autoimmune disease of unknown etiology often misdiagnosed as pneumonia. The hallmark features include necrotizing granulomatous inflammation and pauci-immune vasculitis in small and medium-sized blood vessels. We described a 15-year-old female with a history of six months of acne-like facial and peri-auricular lesions. She had received conventional treatment for acne (antibiotics + topical corticosteroid) with no response. She also had a history of chronic coughs, which always diagnosed and treated as sinusitis. In addition, she had a history of frequent dysuria, which always diagnosed and treated as a urinary tract infection. Given the history, with suspicion of a multi-systemic disease such as vasculitis; we performed some diagnostic laboratory and radiologic tests in order to rule out the possible etiologies. The results were positive for cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA). The urine analysis suggested the involvement of kidney micro-vasculature. In addition, two nodular lesions with the cystic pattern were observed in the CT scan of the lungs. However, the skin and nasal biopsies revealed no evidence of chronic necrotizing vasculitis or granulomatous lesion. Nonetheless, treatment was initiated with a strong suspicion of GPA. Following the treatment, the patient's symptoms completely disappeared, and the diagnosis of GPA was confirmed. © 2020 Bentham Science Publishers.