Journal of Postgraduate Medicine, Education and Research

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VOLUME 57 , ISSUE 1 ( January-March, 2023 ) > List of Articles


A Case of Bilateral Facial Nerve Palsy with Bilateral Cavitary Lung Nodules in a Young Adult

Akhil K Ravi, Deepu Peter

Keywords : Bilateral facial nerve palsy, Glomerulonephritis, Granulomatosis with polyangiitis, Vasculitides

Citation Information : Ravi AK, Peter D. A Case of Bilateral Facial Nerve Palsy with Bilateral Cavitary Lung Nodules in a Young Adult. J Postgrad Med Edu Res 2023; 57 (1):35-37.

DOI: 10.5005/jp-journals-10028-1583

License: CC BY-NC 4.0

Published Online: 10-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Granulomatosis with polyangiitis (GPA) mostly involves the upper and lower respiratory tract with renal involvement. It is a rare disease with varied presentation. However, bilateral facial nerve involvement in this disease is an extremely rare entity. We report a case of a young lady who presented with bilateral facial nerve palsy and was diagnosed as a case of GPA with multisystem involvement.

  1. Lie JT. Illustrated histopathologic classification criteria for selected vasculitis syndromes. American College of Rheumatology Subcommittee on Classification of Vasculitis. Arthritis Rheum 1990;33(8):1074–1087. DOI: 10.1002/art.1780330804
  2. Seo JB, Im JG, Chung JW, et al. Pulmonary vasculitis: the spectrum of radiological findings. Br J Radiol 2000;73(875):1224–1231. DOI: 10.1259/bjr.73.875.11144805
  3. Jolly M, Molta C, Hoffman G. Wegener's granulomatosis: pitfalls in the management of pulmonary disease: a case of Wegener's granulomatosis with a hilar mass. J Rheumatol 2000;27(10): 2511–2512. PubMed: 11036853.
  4. Cotch MF, Hoffman GS, Yerg DE, et al. The epidemiology of Wegener's granulomatosis. Arthritis Rheum 1996;39(1)87–92. DOI: 10.1002/art.1780390112
  5. Jameson JL, Fauci AS, Kasper DL, et al. Vasculitis. In: Harrison's Manual of Medicine. 20th ed. New York, NY: McGraw Hill Education; 2020.
  6. Lee JH, Kim KW, Myong NH, et al. Wegener's granulomatosis presenting as bilateral otalgia with facial palsy: a case report. Korean J Audiol 2013;17(1):35–37. DOI: 10.7874/kja.2013.17.1.35
  7. Iannella G, Greco A, Granata G, et al. Granulomatosis with polyangiitis and facial palsy: literature review and insight in the autoimmune pathogenesis. Autoimmun Rev 2016;15(7):621–631. DOI: 10.1016/j.autrev.2016.02.005
  8. Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum 1990;33(8):1101–1107. DOI: 10.1002/art.1780330807
  9. Hoffman GS, Kerr GS, Leavitt RY, et al. Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 1992;116(6):488–498. DOI: 10.7326/0003-4819-116-6-488
  10. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65(1):1–11. DOI: 10.1002/art.37715
  11. De Groot K, Harper L, Jayne DRW, et al. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial. Ann Intern Med 2009;150(10):670–680. DOI: 10.7326/0003-4819-150-10-200905190-00004
  12. Nachman PH, Hogan SL, Jennette JC, et al. Treatment response and relapse in antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol 1996;7(1):33–39. DOI: 10.1681/ASN.V7133
  13. Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010;363(3):221–232. DOI: 10.1056/NEJMoa0909905
  14. Samson M, Puéchal X, Devilliers H, et al. Mononeuritis multiplex predicts the need for immunosuppressive or immunomodulatory drugs for EGPA, PAN and MPA patients without poor-prognosis factors. Autoimmun Rev 2014;13(9):945–953. DOI: 10.1016/j. autrev.2014.08.002
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