Abstract
Granulomatosis with polyangiitis (GPA) is a form of systemic vasculitis that affects small- and medium-sized blood vessels. It is characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tracts, systemic necrotizing vasculitis, and necrotizing glomerulonephritis. It was first described in 1937 by German pathologist Friedrich Wegener, and till 2011, the disease was called Wegener’s granulomatosis. In January 2011, the Board of Directors of the American College of Rheumatology (ACR), the American Society of Nephrology (ASN), and the European League Against Rheumatism (EULAR) changed the name to disease-descriptive nomenclature, and since 2011, it has been called GPA. Also, the term “limited” GPA was used to describe the isolated disease to the upper respiratory tract and lungs. However, during the disease, systemic involvement was subsequently developed in many patients, and therefore the use of the term “limited” was also left due to its confusing terminology [1–5].
References
Geetha D, Jefferson JA. ANCA-associated vasculitis: CoreCurriculum 2020. Am J Kidney Dis. 2020;75(1):124–37. https://doi.org/10.1053/j.ajkd.2019.04.031.
Grygiel-Górniak B, Limphaibool N, Perkowska K, Puszczewicz M. Clinical manifestations of granulomatosis with polyangiitis: key considerations and major features. Postgrad Med. 2018;130(7):581–96. https://doi.org/10.1080/00325481.2018.1503920.
Greco A, Marinelli C, Fusconi M, et al. Clinic manifestations in granulomatosis with polyangiitis. Int J Immunopathol Pharmacol. 2016;29(2):151–9. https://doi.org/10.1177/0394632015617063.
Lutalo PM, D’Cruz DP. Diagnosis and classification of granulomatosis with polyangiitis (aka Wegener’s granulomatosis). J Autoimmun. 2014;48-49:94–8. https://doi.org/10.1016/j.jaut.2014.01.028.
Comarmond C, Cacoub P. Granulomatosis with polyangiitis (Wegener): clinical aspects and treatment. Autoimmun Rev. 2014;13(11):1121–5. https://doi.org/10.1016/j.autrev.2014.08.017.
Panupattanapong S, Stwalley DL, White AJ, Olsen MA, French AR, Hartman ME. Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations in the United States: analysis of a large National Claims Database. Arthritis Rheumatol. 2018;70(12):2067–76. https://doi.org/10.1002/art.40577.
Pamuk ÖN, Dönmez S, Calayır GB, Pamuk GE. The epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis in northwestern Turkey. Clin Rheumatol. 2016;35(8):2063–71. https://doi.org/10.1007/s10067-016-3232-y.
Kanecki K, Nitsch-Osuch A, Gorynski P, Tarka P, Bogdan M, Tyszko P. Epidemiology of granulomatosis with polyangiitis in Poland, 2011-2015. Adv Exp Med Biol. 2018;1116:131–8. https://doi.org/10.1007/5584_2018_239.
Lyons PA, Rayner TF, Trivedi S, Holle JU, Watts RA, Jayne DR, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012;367:214–23.
Mahr A, Katsahian S, Varet H, Guillevin L, Hagen EC, Hoglund P, et al. Revisiting the classification of clinical phenotypes of anti-neutrophil cytoplasmic antibody-associated vasculitis: a cluster analysis. Ann Rheum Dis. 2013;72:1003–10.
Lionaki S, Blyth ER, Hogan SL, Hu Y, Senior BA, Jennette CE, et al. Classification of anti-neutrophil cytoplasmic autoantibody vasculitides: the role of antineutrophil cytoplasmic autoantibody specificity for myeloperoxidase or proteinase 3 in disease recognition and prognosis. Arthritis Rheum. 2012;64:3452–62.
Miloslavsky EM, Lu N, Unizony S, et al. Myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA)-positive and ANCA-negative patients with granulomatosis with polyangiitis (Wegener’s): distinct patient subsets. Arthritis Rheumatol. 2016;68(12):2945–52. https://doi.org/10.1002/art.39812.
Wojciechowska J, KręCicki T. Clinical characteristics of patients with granulomatosis with polyangiitis and microscopic polyangiitis in ENT practice: a comparative analysis. Acta Otorhinolaryngol Ital. 2018;38(6):517–27. https://doi.org/10.14639/0392-100X-1776.
Guneyli S, Ceylan N, Bayraktaroglu S, et al. Imaging findings of pulmonary granulomatosis with polyangiitis (Wegener’s granulomatosis): lesions invading the pulmonary fissure, pleura or diaphragm mimicking malignancy. Wien Klin Wochenschr. 2016;128(21–22):809–15. https://doi.org/10.1007/s00508-015-0747-1.
Schultz HHL, Victor A, Pedersen L. Severe unilateral lung parenchymal opacities - a unique presentation of granulomatosis with polyangiitis [published online ahead of print, 2020 Jul 30]. Am J Respir Crit Care Med. 2020;202:e117. https://doi.org/10.1164/rccm.202002-0412IM.
El Aoud S, Tounsi H, Chaabène I, et al. Emboliepulmonairebilatéralerévélantunegranulomatoseavecpolyangéite [Bilateralpulmonaryembolismrevealinggranulomatosiswithpolyangiitis]. J Med Vasc. 2018;43(5):316–9. https://doi.org/10.1016/j.jdmv.2018.06.001.
Bautz DJ, Preston GA, Lionaki S, et al. Antibodies with dual reactivity to plasminogen and complementary PR3 in PR3-ANCA vasculitis. J Am Soc Nephrol. 2008;19(12):2421–9. https://doi.org/10.1681/ASN.2008030270.
Filocamo G, Torreggiani S, Agostoni C, Esposito S. Lung involvement in childhood onset granulomatosis with polyangiitis. Pediatr Rheumatol Online J. 2017;15(1):28. Published 2017 Apr 14. https://doi.org/10.1186/s12969-017-0150-8.
Quinn KA, Gelbard A, Sibley C, et al. Subglottic stenosis and endobronchial disease in granulomatosis with polyangiitis. Rheumatology (Oxford). 2019;58(12):2203–11. https://doi.org/10.1093/rheumatology/kez217.
Koldingsnes W, Jacobsen EA, Sildnes T, Hjalmarsen A, Nossent HC. Pulmonary function and high-resolution CT findings five years after disease onset in patients with Wegener’s granulomatosis. Scand J Rheumatol. 2005;34(3):220–8. https://doi.org/10.1080/03009740410011271.
Tzouvelekis A, Karampitsakos T, Krompa A, Markozannes E, Bouros D. False positive COVID-19 antibody test in a case of granulomatosis with polyangiitis. Front Med (Lausanne). 2020;7:399. Published 2020 July 7. https://doi.org/10.3389/fmed.2020.00399.
Říhová E, Svozílková P, Brichová M, Klímová A, Kuthan P, Diblík P. Ocular manifestations of granulomatosis with polyangiitis. OČNÍ PROJEVY GRANULOMATÓZY S POLYANGIITIDOU. Cesk Slov Oftalmol. 2019;74(5):167–74. https://doi.org/10.31348/2018/5/1.
Pérez-JacoisteAsín MA, Charles P, Rothschild PR, et al. Ocular involvement in granulomatosis with polyangiitis: a single-center cohort study on 63 patients. Autoimmun Rev. 2019;18(5):493–500. https://doi.org/10.1016/j.autrev.2019.03.001.
Fragoulis GE, Lionaki S, Venetsanopoulou A, Vlachoyiannopoulos PG, Moutsopoulos HM, Tzioufas AG. Central nervous system involvement in patients with granulomatosis with polyangiitis: a single-center retrospective study. Clin Rheumatol. 2018;37(3):737–47. https://doi.org/10.1007/s10067-017-3835-y.
Szymanowska-Narloch A, Gawryluk D, Błasińska-Przerwa K, Siemińska A. Atypical manifestations of granulomatosis with polyangiitis: the diagnostic challenge for pulmonologists. Adv Respir Med. 2019;87(6):244–53. https://doi.org/10.5603/ARM.2019.0062.
Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, Calabrese LH, Fries JF, Lie JT, Lightfoot RW Jr, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum. 1990;33(8):1101–7. https://doi.org/10.1002/art.1780330807. PMID: 2202308.
Seeliger B, Sznajd J, Robson JC, Judge A, Craven A, Grayson PC, Suppiah RS, Watts RA, Merkel PA, Luqmani RA. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology (Oxford). 2017;56(7):1154–61. https://doi.org/10.1093/rheumatology/kex075. PMID: 28379475; PMCID: PMC6251621.
Robson J, Grayson P, Ponte C, Suppiah R, Craven A, Khalid A, et al. 110. Classification criteria for the ANCA-associated vasculitides. Rheumatology. 2019;58(Supplement_2):kez058.050. https://doi.org/10.1093/rheumatology/kez058.050.
Mahmood FS, Schwatz E, Kurrup S, Sharp C, Hands G, Moody A. A diagnostic dilemma: differentiating between granulomatosis with polyangiitis and tuberculosis. Clin Med (Lond). 2013;13(4):411–3. https://doi.org/10.7861/clinmedicine.13-4-411. PMID: 23908518; PMCID: PMC4954315.
Yates M, Watts RA, Bajema IM, Cid MC, Crestani B, Hauser T, Hellmich B, et al. EULAR/ERA - EDTA recommendations for the management of ANCA-associated vasculitis. Ann Rheum Dis. 2016;75:1583–94.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Karadoğan, D., Dursun, A.B., Pieczyrak, R. (2023). Granulomatosis with Polyangiitis. In: Cingi, C., Yorgancıoğlu, A., Bayar Muluk, N., Cruz, A.A. (eds) Airway diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-22483-6_90-1
Download citation
DOI: https://doi.org/10.1007/978-3-031-22483-6_90-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-22482-9
Online ISBN: 978-3-031-22483-6
eBook Packages: MedicineReference Module Medicine