系统性风湿病的鼻科表现。

文献信息

中文摘要

鼻窦症状是多种系统性炎症性疾病的常见早期表现，并可能先于多系统受累数天至数年出现。由于鼻塞、流涕、鼻出血、结痂和嗅觉减退常被归因于慢性鼻窦炎，因此抗中性粒细胞胞质抗体相关性血管炎、免疫球蛋白G4相关疾病、复发性多软骨炎和结节病等诊断常被延误。识别非典型鼻窦症状及相关系统性表现对于将这些疾病与原发性鼻窦炎症区分开来至关重要。本文聚焦于伴有鼻部受累的风湿性疾病，重点介绍应促使进行系统性评估和疾病特异性管理的关键临床、影像学和组织病理学线索。

英文摘要

Sinonasal symptoms are a common early manifestation of several systemic inflammatory diseases and may precede multisystem involvement by days to years. Because nasal obstruction, drainage, epistaxis, crusting, and hyposmia are frequently attributed to chronic rhinosinusitis, diagnoses such as antineutrophil-cytoplasmic antibody-associated vasculitis, immunoglobulin G4-related disease, relapsing polychondritis, and sarcoidosis are often delayed. Recognition of atypical sinonasal symptoms and associated systemic findings is critical to distinguishing these entities from primary sinonasal inflammation. This article focuses on rheumatologic diseases with nasal involvement, highlighting key clinical, radiographic, and histopathologic clues that should prompt systemic evaluation and disease-specific management.