Granulomatosis polyangiitis, (Wegener Granulomatosis) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Granulomatosis with polyangiitis (Wegener’s Granulomatosis), Diagnosis and Treatment and Related Diseases
Granulomatosis with polyangiitis (Wegener's granulomatosis) is a disease that causes the small blood vessels (arterioles and capillaries) in the body to become inflamed.
Granulomatosis with polyangiitis (GPA) can lead to damage in major organs of the body.
It was formerly known as Wegener's granulomatosis.
Particularly, lungs, throat, nose, sinuses and kidneys become affected.
In the beginning, the symptoms are often vague, such as runny nose or prolonged otitis media that do not recover with standard treatment.
Symptoms from the lungs later develop with cough and breathing difficulty.
Mild fever, fatigue and general malaise are common.
Some people get joint pain, swelling around an eye or skin rash. ‘
Disease of the kidney is normally present late in the course of the disease.
The disease can be serious and life threatening and prompt treatment is important.
GPA is most frequent in middle-aged adults of northern European race.
It is infrequent in children, but has been observed in infants as young as 3 months old.
Causes
The exact cause is not known but it is an autoimmune disorder.
Granulomatosis with polyangiitis manifests itself as a so-called autoimmune disease, meaning that the immune system mistakenly attacks the body's own tissues.
Granulomatosis with polyangiitis is a disease that can become life threatening if not treated.
With the treatment methods available today, most patients recover.
Some will relapse and must be treated again.
Symptoms
Frequent sinusitis and bloody nose are the most frequent symptoms.
Other early symptoms are:
1. A fever that has no clear cause,
2. Night sweats,
3. Fatigue, and
4. A general ill feeling (malaise).
Other frequent symptoms may be:
1. Chronic ear infections
2. Pain, and sores around the opening of the nose
3. Cough with or without blood in the sputum
4. Chest pain and shortness of breath as the disease progresses
5. Loss of appetite and weight loss
6. Skin changes such as bruises and ulcers of the skin
7. Kidney problems
8. Bloody urine
9. Eye problems ranging from mild conjunctivitis to severe swelling of the eye
Diagnosis
When the doctor suspects the disease, it may be because of medical examination of the body showed presence of signs of the disease.
It will have blood tests and various imaging studies.
Detection of specific types of antibodies (cANCA), high blood sedimentation rate, or renal impairment strengthens the suspicion of the diagnosis.
A chest x-ray will be done to look for signs of lung disease.
Urinalysis is done to look for signs of kidney disease such as protein and blood in the urine.
Blood tests are done to rule out other illnesses:
1. Antinuclear antibodies
2. Anti-glomerular basement membrane (anti-GBM) antibodies
3. C3 and C4, cryoglobulins, hepatitis serologies, HIV
Tissue samples can help to confirm the diagnosis.
Treatment
It is essential to medically treat the patient for him or her to become healthy.
The treatment is lengthy, often lasting 2-3 years.
The patient will probably be treated with glucocorticoids
These are given along with other immunosuppresants that reduce down the immune response.
Medicines used with prednisone to treat GPA are:
1. Cyclophosphamide with high-dose glucocorticoids (criterion standard)
2. Rituximab
3. Methotrexate (oral or subcutaneous)
Plasma exchange may be indicated in patients with rapidly progressive renal disease
For the next two years the doctors normally used a maintenance chemotherapy, methotrexate.
Folic acid tablets are given to prevent deficiency.

TABLE OF CONTENT
Introduction
Chapter 1 Granulomatosis Polyangiitis (Wegener Granulomatosis)
Chap

• Language: English
• Publisher: Kenneth Kee
• Release date: May 7, 2019
• ISBN: 9780463726150

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Granulomatosis polyangiitis,

(Wegener Granulomatosis)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Granulomatosis with polyangiitis (Wegener’s Granulomatosis), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Granulomatosis with polyangiitis)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

These are simple guides and not meant as textbooks.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog: http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Granulomatosis with polyangiitis

What is Granulomatosis with polyangiitis?

Granulomatosis with polyangiitis (Wegener's granulomatosis) is a disease that causes the small blood vessels (arterioles and capillaries) in the body to become inflamed.

Granulomatosis with polyangiitis (GPA) can lead to damage in major organs of the body.

It was formerly known as Wegener's granulomatosis.

Particularly, lungs, throat, nose, sinuses and kidneys become affected.

In the beginning, the symptoms are often vague, such as runny nose or prolonged otitis media that do not recover with standard treatment.

Symptoms from the lungs later develop with cough and breathing difficulty.

Mild fever, fatigue and general malaise are common.

Some people get joint pain, swelling around an eye or skin rash. ‘

Disease of the kidney is normally present late in the course of the disease.

Granulomatosis with polyangiitis is a rare disease that can be very severe without treatment.

GPA mainly affects blood vessels in:

1. The lungs,

2. Kidneys,

3. Nose,

4. Sinuses, and

5. Ears.

Other areas may also be affected in some cases.

The disease can be serious and life threatening and prompt treatment is important.

GPA is most frequent in middle-aged adults of northern European race.

It is infrequent in children, but has been observed in infants as young as 3 months old.

What are the causes of the Granulomatosis with polyangiitis?

Causes

The exact cause is not known but it is an autoimmune disorder.

Granulomatosis with polyangiitis manifests itself as a so-called autoimmune disease, meaning that the immune system mistakenly attacks the body's own tissues.

Granulomatosis with polyangiitis is a disease that can become life threatening if not treated.

With the treatment methods available today, most patients recover.

Some will relapse and must be treated again.

Some are long-term effects of treatment.

Doctors advise regular checks for years to come even if the patient has been completely healthy.

What are the symptoms of the Granulomatosis with polyangiitis?

Symptoms

Frequent sinusitis and bloody nose are the most frequent symptoms.

Other early symptoms are:

1. A fever that has no clear cause,

2. Night sweats,

3. Fatigue, and

4. A general ill feeling (malaise).

Other frequent symptoms may be:

1. Chronic ear infections

2. Pain, and sores around the opening of the nose

3. Cough with or without blood in the sputum

4. Chest pain and shortness of breath as the disease progresses

5. Loss of appetite and weight loss

6. Skin changes such as bruises and ulcers of the skin

7. Kidney problems

8. Bloody urine

9. Eye problems ranging from mild conjunctivitis to severe swelling of the eye

Less common symptoms are:

1. Joint pain

2. Weakness

3. Abdominal pain

How is the diagnosis of Granulomatosis with polyangiitis made?

Diagnosis

When the doctor suspects the disease, it may be because of medical examination of the body showed presence of signs of the disease.

The purpose is to determine which organs are affected.

It will have blood tests