Sarcouncil Journal of Medical Sciences

Abstract: The upper airway (UA) is a common target of systemic vasculitis, especially ANCA-associated vasculitis (AAV), often leading to it being a primary presenting site. The proposed research seeks to examine clinical associations of upper airway involvement (UAI) in patients with systemic vasculitis, assessing the diagnostic value of ENT manifestations and their effect on patient quality of life and treatment responses. A cross-sectional study was conducted at different hospitals in Iraq from February 2025 to February 2026. This research was an investigation of inflammatory markers in a group of vasculitis patients. ENT involvement was reported and described in a group of 124 patients with systemic vasculitis (mainly granulomatosis with polyangiitis [GPA]) and was described at sinonasal, otologic, and upper aerodigestive locations. Data contained ANCA serology (PR3-ANCA and MPO-ANCA), duration of UAI symptoms, complications, and quality of life using SNOT-22 scores before and after treatment. Chronic rhinosinusitis (68.3%) and nasal septal perforation (25.2% of patients) were commonly encountered. PR3-ANCA positivity was more strongly associated with UAI compared to MPO-ANCA serologically. Glucocorticoids (95.9), cyclophosphamide (55.3), and rituximab (34.1) were heavily used. ENT complications were septal perforation (28.5%). The quality of life was significantly improved as SNOT-22 went down to 22.1 after treatment compared to 58.4 before treatment. The rates of relapse varied depending on the UAI course: 44.5% in the individuals who experienced persistent UAI and 18.2% in the individuals who experienced resolved UAI. Systemic vasculitis involves upper airway involvement that is common and clinically relevant, with a high diagnostic delay, a common sinonasal disease, and quality-of-life loss. The results justify a significant correlation between the PR3-ANCA positivity and UAI and prove that effective therapy is linked to significant sinonasal symptom burden reduction.