A Case of Eosinophilic Granulomatosis with Polyangiitis Associated with Posterior Auricular Arteritis

DOI Open Access
  • Fujikawa Taro
    Department of Otorhinolaryngology, Tokyo Medical and Dental University
  • Oba Seiya
    Department of Rheumatology, Tokyo Medical and Dental University
  • Kawashima Yoshiyuki
    Department of Otorhinolaryngology, Tokyo Medical and Dental University
  • Makabe Ayane
    Department of Otorhinolaryngology, Tokyo Medical and Dental University
  • Ito Taku
    Department of Otorhinolaryngology, Tokyo Medical and Dental University
  • Takeda Takamori
    Department of Otorhinolaryngology, Tokyo Medical and Dental University
  • Tsutsumi Takeshi
    Department of Otorhinolaryngology, Tokyo Medical and Dental University

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Other Title
  • 好酸球性多発血管炎性肉芽腫症の耳科学的臨床像―好酸球性中耳炎との比較において

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Abstract

<p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis affecting small-sized vessels of the lungs and nervous system. However, otologic presentations are often dominant early in the course of EGPA, making it difficult to differentiate EGPA from eosinophilic otitis media (EOM). Here we demonstrate a case of EGPA showing otitis media as the major symptom, and statistically compare clinical profiles of EGPA and EOM. Results revealed that the most typical otologic manifestation of EGPA is chronic otitis with granulating inflammation mainly affecting the posterior part of the meatus and ear drum. Gadolinium-enhanced 3D fast spoiled gradient-recalled imaging indicated the presence of posterior auricular arteritis as a potential etiology of granulomatous otitis of EGPA. However, vestibular examinations, including vestibular evoked myogenic potential, indicated the involvement of other vessels in the inner ear. Unlike EOM, peripheral neuropathy, facial nerve paresis and eosinophilia were specific to EGPA.</p>

Journal

  • Otology Japan

    Otology Japan 29 (1), 45-51, 2019

    Japan Otological Society

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