Granulomatosis with Polyangiitis (GPA) - Symptoms and Signs

Symptoms and Signs

Symptoms of Granulomatosis with Polyangiitis (GPA) are usually related to the upper airways, lungs and kidneys.

Granulomatosis with Polyangiitis (GPA) affects the upper airways, lungs and kidneys. Rhinitis or running nose and stuffiness maybe the first presenting symptom of the condition.

The patient usually shows the following clinical features:

• He may experience general symptoms like fever, weakness, and loss of appetite and weight.
• He may have symptoms of sinus pain, nasal discharge, nose ulcers and bleeds, and deafness due to inflammation of the upper airways. The bridge

  of the nose may be perforated and even collapsed due to lack of blood supply. The windpipe may narrow leading to difficulty in breathing and death.

• The patient may show symptoms of cough, difficulty in breathing and chest pain if the lungs are affected. He may suffer from bleeding into the lung sacs and may cough up blood. He may suffer from accumulation of fluid just outside the lungs. His lungs may collapse.
• The patient may have no symptoms when his kidneys are affected. Urine tests may indicate the presence of blood and/or protein in the urine. He may progress to kidney failure.

• The patient may suffer from pain and swelling in the joints and muscle pain.
• The eyes may be inflamed and lead to protrusion of eyeballs and blindness.
• Skin may show small swellings or bleedings under the skin.
• Nerves may be involved resulting in wrist drop or foot drop.
• The brain and the covering of the heart may be affected in rare cases.

References

1. Langford CA. Update on Granulomatosis with Polyangiitis (GPA). Cleveland Clinic Journal of Medicine 2005; 72 (8): 689 � 697.
2. Harrison�s Principles of Internal Medicine 17^th edition.