Wenn der Schnupfen lebensgefährlich wird: Rezidivierende Sinusitis und Mastoiditis als Beginn einer Systemerkrankung

A 30-year-old woman presented with remitting upper airway infections. Over time she developed mastoiditis resistant to antibiotics, arthritis of her ankle as well as multilocular arthralgias and a livid discoloration of her fingertips. A computed tomography (CT) scan of her chest revealed a cavernous process and c‑ANCA (Anti Neutrophilen Cytoplasmatic Antibody) positivity led to the diagnosis granulomatosis with polyangiitis (formerly called Wegener’s). In line with literature reports, rituximab and cortisosteroid therapy quickly induced remission.