Case Report

Atypical Endobronchial Carcinoid with Postobstructive Pneumonia Obscuring the Diagnosis of Granulomatosis with Polyangiitis

Table 1

Organ-based clinical features of granulomatosis with polyangiitis.

ConstitutionalMalaise, myalgia, arthralgia, anorexia, weight loss, and pyrexia

Mucocutaneous and orbitalOral ulcers, oral granulomatous lesions, episcleritis, scleritis, conjunctivitis, keratitis, uveitis, retinal vasculitis, retinal artery or venous thrombosis, retinal exudates, retinal hemorrhages, blurred vision, blindness, proptosis, and orbital granulomatous masses

CutaneousInfarcts leading to ulcers and gangrene; leukocytoclastic vasculitis that may be found on biopsy

Ear and nose Sensorineural and conductive hearing loss, persistent/recurrent nasal discharge +/− bloody, nasal ulceration, nose bridge collapse, nasal granulomatous lesions, and parasinus and sinus inflammation

Upper airwaySubglottic or tracheal stenosis, stridor

Lower airwayCough, dyspnea, wheeze, hemoptysis, small airway obstruction, pulmonary infiltrates and hemorrhage leading to respiratory failure, and pleuritis

RenalHematuria, proteinuria, cellular cast on urine cytology; renal impairment in the form of acute kidney injury, chronic kidney disease, or end stage renal disease; diffuse pauci-immune crescentic necrotizing glomerulonephritis on biopsy

CardiovascularOcclusive vascular disease, pericarditis, pericardial effusions, cardiomyopathy, valvular heart disease, ischemic heart disease, and heart failure

GastrointestinalPeritonitis, bowel ischemia secondary to mesenteric vasculitis

Central and peripheral nervous systemsHeadache, meningitis, seizures, cerebrovascular accidents, spinal cord lesions, cranial nerve palsies, sensory or motor peripheral neuropathy, mononeuritis multiplex, and cerebral mass lesion