PT  - JOURNAL ARTICLE
AU  - Al-Hakami, Hasan
AU  - Al-Arfaj, Abdurhman S.
AU  - Al-Sohaibani, Mohammed
AU  - Khalil, Najma A.
TI  - An eosinophilic variant granulomatosis with polyangiitis involving the dura, bilateral orbits, and mastoids
AID  - 10.15537/smj.2016.6.14718
DP  - 2016 Jun 01
TA  - Saudi Medical Journal
PG  - 690--693
VI  - 37
IP  - 6
4099  - http://smj.org.sa/content/37/6/690.short
4100  - http://smj.org.sa/content/37/6/690.full
SO  - Saudi Med J2016 Jun 01; 37
AB  - Granulomatosis with polyangiitis (GPA) formerly called Wegener’s granulomatosis is a chronic necrotizing granulomatous inflammatory disease with systemic vasculitis involving the upper and lower respiratory tract, and kidneys. The typical histopathology is that of necrotizing granulomatous inflammation with palisading histiocytes, neutrophils, and lymphocytes. We report a case of a 57-year-old lady presenting with left eye swelling, left ear pain and discharge, but with no pulmonary or renal symptoms. Investigations revealed positive cytoplasmic antineutrophil cytoplasmic antibodies and proteinase 3 antibodies. The CT and MRI showed meningeal thickening and bilateral structural changes of the orbits and mastoids. Lacrimal gland biopsy showed non necrotizing granulation with an eosinophilic infiltration. She was diagnosed with eosinophilic variant of GPA of the eyes and mastoid bones bilaterally extending to dura and sparing the lungs and kidneys. She responded to corticosteroids and rituximab.