The variety of clinical symptoms as a cause of difficulty in correct diagnosis of granulomatosis with polyangiitis

Abstract

The essence of granulomatosis with polyangiitis (GPA) is the occurrence of necrotizing granulomatous vasculitis of medium and small vessels. Particularly, the respiratory tract and the kidneys are predisposed to this disease. We present the case of a 65-year-old woman in whom GPA was diagnosed. The occurrence of non-specific clinical signs contributed to the fact that the disease remains undiagnosed for a long time. The predominant symptom was treatment-resistant, long-term skin ulceration in the right leg. No therapeutic effect of long-term treatment of ulcers should lead to further evaluation and a search for other causes of symptoms. Implementation of effective treatment prevents complications in GPA, which is possible by establishing a rapid diagnosis.

Keywords

• granulomatosis with polyangiitis
• leg ulceration
• renal dialysis