Wegener’s granulomatosis (WG) – Nose and paranasal sinuses:


Nose and paranasal sinuses:

The nasal cavity and the paranasal sinuses are affected in 60 to
90%.

The clinical manifestation shows a broad spectrum
minimal nasal obstruction up to major destruction
of the outer nose and the structures of the
paranasal sinuses including the involvement of the central nervous
system through damage to the skull base.The most common
nasal symptoms in these patients are nasal obstruction
and discharge.septal perforation, a reduction in sense of smell
and through this taste, and pain in the area of the nose. A septal
perforation is a stronger sign
, particularly if there is no history
of nasal trauma or septal surgery.
Sinusitis, presenting with headache, chronic
nasal congestion
and mucopurulent discharge occur in up to
50% of these patients.
Epiphora as a sign for direct involvement of lacrimal duct or
secondary blockage to the same by granulomatous lesions from the nose.

The nasal mucosa frequently has a chronic infection with Staphylococcus
aureus with no or few symptoms. It is suggested, that the
chronic existence of S. aureus may reactivate disease activity of
WG. However it is assumed to be caused by superantigens of S. aureus

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