Parotid Sinus Secondary to Granulomatosis with Polyangiitis: A Case Report

Granulomatosis with polyangiitis (GPA) or Wegener’s granulomatosis is a multisystemic disease with a complex genetic background. The clinical presentations are characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract, glomerulonephritis, and small-vessel vasculitis.1 Systemic symptoms of GPA are nonspecific and include fatigue, fever, arthralgia, and weight loss. Head and neck manifestations occur in 90% of patients. The nose and paranasal sinuses are most commonly affected in up to 80%.2 Nasal symptoms include serosanguinous discharge and headache and pain over the dorsum. Nasal findings include crusts covering friable mucosa, ulceration, septal perforation, and saddle-nose deformity. Involvement of salivary glands occurs in less than 1%.3 A high level of clinical suspicion and appropriate diagnostic and laboratory investigations are crucial for early diagnosis. We report a case of bilateral parotid gland swelling and pus-draining parotid sinus secondary to GPA and discuss its presentations and management. The study was approved by the ethics committee of Alexandria Faculty of Medicine