Systemic inflammatory conditions
Granulomatosis with polyangiitis or Wegener’s granulomatosis is a vasculitic disorder, primarily affecting the triad of organs: upper respiratory tract, lungs and kidneys.
The rhinological manifestation of the disease include symptoms such as nasal congestion, rhinorrhoea and anosmia. This can progress to rhinitis, sinusitis, septal perforation (presenting as saddle-nose deformity) or nasal airway stenosis.
On investigation, there will be raised ESR, c-ANCA and deranged haemoglobin and creatinine. A nasal biopsy is required to diagnose the disease. Treatments include: cyclophosphamide, methotrexate ± steroids. New therapeutic agents include rituximab.
Myocarditis is a rare complication of the condition.