open access

Vol 87, No 6 (2019)
CASE REPORTS
Published online: 2020-01-14
Submitted: 2019-05-20
Accepted: 2019-09-05
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Difficulties in recognizing granulomatosis with polyangiitis (GPA) in elderly patients undergoing diagnostic thoracotomy twice — a report of two cases

Justyna Fijołek, Elżbieta Wiatr, Dariusz Gawryluk, Renata Langfort, Kazimierz Roszkowski-Śliż
DOI: 10.5603/ARM.2019.0064
·
Pubmed: 31970728
·
Adv Respir Med 2019;87(6):258-264.

open access

Vol 87, No 6 (2019)
CASE REPORTS
Published online: 2020-01-14
Submitted: 2019-05-20
Accepted: 2019-09-05

Abstract

Granulomatosis with polyangiitis (GPA) is defined as a necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract with necrotizing vasculitis affecting predominantly small to medium vessels. Because of non-specific symptoms, its radiological presentation, and the diversity of its clinical expression, it is not uncommon to for it to be misdiagnosed, especially in the elderly. Although biopsy and histological examination seem to be essential for GPA diagnosis, their results are sometimes ambiguous and not helpful in making a decision. In this report, we present difficulties in the recognition of GPA in two elderly patients in whom, despite twice performing a diagnostic thoracotomy, GPA was recognized almost 4 and 6 years after the first symptoms.

Abstract

Granulomatosis with polyangiitis (GPA) is defined as a necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract with necrotizing vasculitis affecting predominantly small to medium vessels. Because of non-specific symptoms, its radiological presentation, and the diversity of its clinical expression, it is not uncommon to for it to be misdiagnosed, especially in the elderly. Although biopsy and histological examination seem to be essential for GPA diagnosis, their results are sometimes ambiguous and not helpful in making a decision. In this report, we present difficulties in the recognition of GPA in two elderly patients in whom, despite twice performing a diagnostic thoracotomy, GPA was recognized almost 4 and 6 years after the first symptoms.

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Keywords

GPA, elderly patients, diagnostic difficulties

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About this article
Title

Difficulties in recognizing granulomatosis with polyangiitis (GPA) in elderly patients undergoing diagnostic thoracotomy twice — a report of two cases

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 6 (2019)

Pages

258-264

Published online

2020-01-14

DOI

10.5603/ARM.2019.0064

Pubmed

31970728

Bibliographic record

Adv Respir Med 2019;87(6):258-264.

Keywords

GPA
elderly patients
diagnostic difficulties

Authors

Justyna Fijołek
Elżbieta Wiatr
Dariusz Gawryluk
Renata Langfort
Kazimierz Roszkowski-Śliż

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