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Polyps, grommets and eosinophilic granulomatosis with polyangiitis

Published online by Cambridge University Press:  09 January 2018

F G Kavanagh ,
W Hasan ,
D A Smyth  and
J E Fenton
F G Kavanagh*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Ireland
W Hasan
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Ireland
D A Smyth
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Ireland
J E Fenton
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, University Hospital Limerick, Ireland Graduate Entry Medical School, University of Limerick, Ireland
*
Address for correspondence: Dr Fergal Kavanagh, Department of Otolaryngology, Head and Neck Surgery, University Hospital, Newcastle Road, Galway, Ireland E-mail: [email protected]
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Abstract

Objective:

To explore the link between nasal polyposis, refractory otitis media with effusion and eosinophilic granulomatosis with polyangiitis.

Methods:

A retrospective observational study was carried out of patients diagnosed with refractory otitis media with effusion necessitating grommet insertion and who had nasal polyps. Patients were evaluated to determine if they fulfilled the diagnostic criteria of eosinophilic granulomatosis with polyangiitis.

Results:

Sixteen patients (10 males and 6 females) were identified. The mean age of grommet insertion was 45.4 years. The mean number of grommets inserted per patient was 1.6. The mean number of nasal polypectomies was 1.7. All 16 patients had paranasal sinus abnormalities and otitis media with effusion, 14 had asthma, 9 had serological eosinophilia and 7 had extravascular eosinophilia. Nine patients met the diagnostic criteria for eosinophilic granulomatosis with polyangiitis.

Conclusion:

The co-presence of nasal polyps and resistant otitis media with effusion should raise the possibility of eosinophilic granulomatosis with polyangiitis.

Keywords

Middle Ear VentilationNasal PolypsAsthmaOtitis Media With EffusionRetrospective StudiesEosinophiliaOtitis MediaParanasal Sinuses
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 3 , March 2018 , pp. 236 - 239
Copyright
Copyright © JLO (1984) Limited 2018 

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Footnotes

Presented orally at the 57th Irish Otorhinolaryngology/Head and Neck Surgery Society Annual Meeting, 14 October 2016, Lough Eske, Ireland, and at the 25th Congress of the European Rhinologic Society, 22–26 June 2014, Amsterdam, The Netherlands.

References

1 Churg, J, Strauss, L. Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 1951;27:277–301 Google ScholarPubMed
2 Taki, H, Shinoda, K, Hounoki, H, Ogawa, R, Ishizawa, S, Sugiyama, E et al. Serum interleukin-5 levels correlate with disease activity of Churg-Strauss syndrome in a patient treated with a leucotriene receptor antagonist, pranlukast, and inhaled corticosteroid. Scand J Rheumatol 2010;39:341–3Google Scholar
3 Sinico, RA, Di Toma, L, Maggiore, U, Bottero, P, Radice, A, Tosoni, C et al. Prevalence and clinical significance of antineutrophil cytoplasmic antibodies in Churg-Strauss syndrome. Arthritis Rheum 2005;52:2926–35Google Scholar
4 Guillevin, L, Cohen, P, Gayraud, M, Lhote, F, Jarrousse, B, Casassus, P. Churg-Strauss syndrome: clinical study and long-term follow-up of 96 patients. Medicine (Baltimore) 1999;78:26–37 Google Scholar
5 Olsen, KD, Neel, HB 3rd, DeRemee, RA, Weiland, LH. Nasal manifestations of allergic granulomatosis and angiitis (Churg-Strauss syndrome). Otolaryngol Head Neck Surg 1980;88:85–9Google Scholar
6 Martinez Del Pero, M, Moffat, D, Sudhoff, H. Unusual presentation of temporal bone involvement in Churg-Strauss syndrome. J Laryngol Otol 2008;122:425–7CrossRefGoogle ScholarPubMed
7 Ovadia, S, Dror, I, Zubkov, T, Tanay, A, Levy, D, Zandman-Goddard, G. Churg–Strauss syndrome: a rare presentation with otological and pericardial manifestations: case report and review of the literature. Clin Rheumatol 2009;28(suppl 1):S35–8 Google Scholar
8 Bacciu, A, Buzio, C, Giordano, D, Pasanisi, E, Vincenti, V, Mercante, G et al. Nasal polyposis in Churg-Strauss syndrome. Laryngoscope 2008;118:325–9Google Scholar
9 Comarmond, C, Pagnoux, C, Khellaf, M, Cordier, JF, Hamidou, M, Viallard, JF et al. ; French Vasculitis Study Group. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort. Arthritis Rheum 2013;65:270–81Google Scholar
10 Ribi, C, Cohen, P, Pagnoux, C, Mahr, A, Arène, JP, Lauque, D et al. ; French Vasculitis Study Group. Treatment of Churg-Strauss syndrome without poor-prognosis factors: a multicenter, prospective, randomized, open-label study of seventy-two patients. Arthritis Rheum 2008;58:586–94Google Scholar
11 Johansson, L, Akerlund, A, Holmberg, K, Melén, I, Bende, M. Prevalence of nasal polyps in adults: the Skövde population-based study. Ann Otol Rhinol Laryngol 2003;112:625–9Google Scholar
12 Scadding, GK, Durham, SR, Mirakian, R, Jones, NS, Drake-Lee, AB, Ryan, D et al. ; British Society for Allergy and Clinical Immunology. BSACI guidelines for the management of rhinosinusitis and nasal polyposis. Clin Exp Allergy 2008;38:260–75Google Scholar
13 Tewfik, TL, Mazer, B. The links between allergy and otitis media with effusion. Curr Opin Otolaryngol Head Neck Surg 2006;14:187–90Google Scholar
14 Parietti-Winkler, C, Baumann, C, Gallet, P, Gauchard, G, Jankowski, R. Otitis media with effusion as a marker of the inflammatory process associated to nasal polyposis. Rhinology 2009;47:396–9Google Scholar
15 Rosenfeld, RM, Culpepper, L, Doyle, KJ, Grundfast, KM, Hoberman, A, Kenna, MA et al. ; American Academy of Pediatrics Subcommittee on Otitis Media with Effusion; American Academy of Family Physicians; American Academy of Otolaryngology–Head and Neck Surgery. Clinical practice guideline: otitis media with effusion. Otolaryngol Head Neck Surg 2004;130(5 suppl):S95–118 Google Scholar
16 Nagamine, H, Iino, Y, Kojima, C, Miyazawa, T, Iida, T. Clinical characteristics of so called eosinophilic otitis media. Auris Nasus Larynx 2002;29:19–28 Google Scholar
17 Iino, Y, Tomioka-Matsutani, S, Matsubara, A, Nakagawa, T, Nonaka, M. Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease. Auris Nasus Larynx 2011;38:456–61Google Scholar
18 Gleich, GJ, Adolphson, CR. The eosinophilic leukocyte: structure and function. Adv Immunol 1986;39:177–253 Google Scholar
19 Gotlib, J. Molecular classification and pathogenesis of eosinophilic disorders: 2005 update. Acta Haematol 2005;114:7–25 Google Scholar
20 Lanham, JG, Elkon, KB, Pusey, CD, Hughes, GR. Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome. Medicine (Baltimore) 1984;63:65–81 Google Scholar
21 Spry, CJ. Eosinophils: A Comprehensive Review, and Guide to the Scientific and Medical Literature. Oxford: Oxford University Press, 1988 Google Scholar
22 Guillevin, L, Pagnoux, C, Seror, R, Mahr, A, Mouthon, L, Le Toumelin, P; French Vasculitis Study Group (FVSG). The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore) 2011;90:19–27 Google Scholar
23 Bourgarit, A, Le Toumelin, P, Pagnoux, C, Cohen, P, Mahr, A, Le Guern, V et al. ; French Vasculitis Study Group. Deaths occurring during the first year after treatment onset for polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome: a retrospective analysis of causes and factors predictive of mortality based on 595 patients. Medicine (Baltimore) 2005;84:323–30Google Scholar
24 Ishiyama, A, Canalis, RF. Otological manifestations of Churg-Strauss syndrome. Laryngoscope 2001;111:1619–24Google Scholar
25 Keogh, KA, Specks, U. Churg-Strauss syndrome: clinical presentation, antineutrophil cytoplasmic antibodies, and leukotriene receptor antagonists. Am J Med 2003;115:284–90Google Scholar