В Нидерландах разработали рекомендации по ранней диагностике ЛОР-проявлений васкулита

In patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), there are critical clinical challenges in terms of diagnostic delays and the lack of standardized tracking tools for ear, nose, and throat (ENT) disease manifestations. In a new analysis published recently in the European Archives of Oto-Rhino-Laryngology, researchers conducted a multicenter, qualitative, exploratory study in The Netherlands. They analyzed findings from in-depth interviews of 4 Dutch otorhinolaryngologists. “The aim of the questions in this interview was to understand how otorhinolaryngologists handle patients with AAV from diagnosis to follow-up.” The experts who were interviewed responded to statements regarding ENT symptoms and rhinoscopic findings associated with AAV. They created an online survey where respondents rated a series of items using an agreement scale of 0 to 10. Overall, 86.2% (25 of 29) of the surveys sent to the otorhinolaryngologists were completed. The survey results revealed that nasal crusting (rated 9.3 of 10), mucosal hemorrhage (rated 8.8 of 10), and septal perforation (rated 8.6 of 10) were identified as the rhinoscopic findings most strongly associated with a high suspicion of AAV. Symptoms deemed to be rated the highest in terms of supporting the presence of active AAV included nasal crusting (rated 9.7 of 10), failure of conventional treatments for chronic rhinosinusitis (7.6 of 10), systemic symptoms (7.5 of 10), and epistaxis (7.5 of 10). There were multiple recommendations provided by the respondents regarding nasal hygiene and using a conservative treatment approach in patients with AAV who present with ENT involvement. In this respect, the survey respondents agreed strongly that thorough nasal hygiene instructions should be provided to all patients (rated 9.1 of 10), ENT involvement should be monitored by an otorhinolaryngologist (8.3 of 10), and nasal lavage should be performed prior to rhinoscopy (7.6 of 10). “These findings may facilitate the establishment of a standardized scoring system to optimize diagnostic accuracy and disease monitoring,” the authors concluded. Currently, there is no standardized tool in place to evaluate AAV-associated activity in the ENT region. Among patients with AAV who experience ENT involvement, diagnostic delays are frequently prolonged because of the wide range of potential symptoms and a general lack of awareness regarding how the disease manifests in this region. The current study was performed between March 2022 and April 2024. Among 36 otorhinolaryngologists who were invited to complete the survey, 29 questionnaires were started and 5 were actually completed. Of the survey respondents, three-fourths were working in regional clinics. This article originally appeared on Rare Disease Advisor References: Krol RM, Christiaans J, Frima A, Kamalski DMA, Spierings J, van der Goes MC. Recognition of ear, nose and throat involvement in patients with ANCA-associated vasculitis: from in-depth interviews to insights for the future. Eur Arch Otorhinolaryngol. Published online August 7, 2026. doi:10.1007/s00405-026-10517-0