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Case Report

Difficulties in Recognizing Granulomatosis with Polyangiitis (GPA) in Elderly Patients Undergoing Diagnostic Thoracotomy Twice—A Report of Two Cases

by
Justyna Fijołek
1,*,
Elżbieta Wiatr
1,
Dariusz Gawryluk
1,
Renata Langfort
2 and
Kazimierz Roszkowski-Śliż
1
1
Third Department of Pneumonology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
2
Department of Pathology, National Tuberculosis and Lung Diseases R esearch Institute, Warsaw, Poland
*
Author to whom correspondence should be addressed.
Adv. Respir. Med. 2019, 87(6), 258-264; https://doi.org/10.5603/ARM.2019.0064
Submission received: 20 May 2019 / Revised: 5 September 2019 / Accepted: 5 September 2019 / Published: 14 January 2020

Abstract

Granulomatosis with polyangiitis (GPA) is defined as a necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract with necrotizing vasculitis affecting predominantly small to medium vessels. Because of non-specific symptoms, its radiological presentation, and the diversity of its clinical expression, it is not uncommon to for it to be misdiagnosed, especially in the elderly. Although biopsy and histological examination seem to be essential for GPA diagnosis, their results are sometimes ambiguous and not helpful in making a decision. In this report, we present difficulties in the recognition of GPA in two elderly patients in whom, despite twice performing a diagnostic thoracotomy, GPA was recognized almost 4 and 6 years after the first symptoms.
Keywords: GPA; elderly patients; diagnostic difficulties GPA; elderly patients; diagnostic difficulties

Share and Cite

MDPI and ACS Style

Fijołek, J.; Wiatr, E.; Gawryluk, D.; Langfort, R.; Roszkowski-Śliż, K. Difficulties in Recognizing Granulomatosis with Polyangiitis (GPA) in Elderly Patients Undergoing Diagnostic Thoracotomy Twice—A Report of Two Cases. Adv. Respir. Med. 2019, 87, 258-264. https://doi.org/10.5603/ARM.2019.0064

AMA Style

Fijołek J, Wiatr E, Gawryluk D, Langfort R, Roszkowski-Śliż K. Difficulties in Recognizing Granulomatosis with Polyangiitis (GPA) in Elderly Patients Undergoing Diagnostic Thoracotomy Twice—A Report of Two Cases. Advances in Respiratory Medicine. 2019; 87(6):258-264. https://doi.org/10.5603/ARM.2019.0064

Chicago/Turabian Style

Fijołek, Justyna, Elżbieta Wiatr, Dariusz Gawryluk, Renata Langfort, and Kazimierz Roszkowski-Śliż. 2019. "Difficulties in Recognizing Granulomatosis with Polyangiitis (GPA) in Elderly Patients Undergoing Diagnostic Thoracotomy Twice—A Report of Two Cases" Advances in Respiratory Medicine 87, no. 6: 258-264. https://doi.org/10.5603/ARM.2019.0064

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