Case report: Two cases of granulomatosis with polyangiitis with different manifestations and clinical responses.

Reporte de caso: Dos casos de granulomatosis con poliangeitis con manifestaciones y respuesta clínica diferentes

Polyangiitis with granulomatosis, previously called Wegener's granulomatosis, is a necrotizing vasculitis of small and medium vessels, characterized by the formation of necrotizing granulomas that mainly affect the upper respiratory tract, lungs and kidneys. Clinically, it presents with symptoms such as chronic sinusitis, hemoptysis, dyspnea, rapidly progressive glomerulonephritis, and systemic manifestations such as fever, weight loss, and asthenia. Diagnosis is based on detecting anti-neutrophil cytoplasmic antibodies (ANCA) type PR3 and histopathological studies. Treatment includes immunosuppressants, such as corticosteroids and cyclophosphamide or rituximab, to induce remission.

Two clinical cases with diagnoses of polyangiitis with granulomatosis are reported. One was a 58-year-old man with orbital involvement, saddle nose, recurrent epistaxis, chronic rhinosinusitis and bilateral pulmonary cavitary involvement. A second case is a 44-year-old man with chronic rhinosinusitis, recurrent epistaxis, hearing loss, and bilateral trachea bronchial stenosis chondritis. Both cases have been positive for C-ANCA, the first with a lung biopsy revealing necrotizing vasculitis and the second with a positive skin biopsy for necrotizing vasculitis. In both cases, induction treatment started with an excellent response and is currently being maintained.