Cuando la otitis no es infecciosa: granulomatosis con poliangeítis con compromiso otológico, nasal y cutáneo

Mayra Lizeth Coral-Gaón; David Camilo Imbachi-Campos; Laura Valentina González-Bolaños; Juan David Pantoja-Torres; Adriana Marcela Fernández-Diago; Julian Andres Sanchez-Sanchez; Estefanía Andrea Aranda-Sierra; Laura Daniela Rojas-Torres; Luisa Fernanda Toro-Torres

Autores/as

Coral-Gaón Mayra Lizeth Médica, Especialista en Docencia Universitaria Universidad Cooperativa de Colombia. San Juan de Pasto, Colombia. https://orcid.org/0009-0001-6970-8918
Imbachi-Campos David Camilo Universidad Icesi. Cali, Colombia. https://orcid.org/0009-0008-3925-3941
González-Bolaños Laura Valentina Universidad de Manizales. Manizales, Colombia. https://orcid.org/0009-0000-1147-6109
Pantoja-Torres Juan David Universidad del Cauca. Popayán, Colombia. https://orcid.org/0009-0006-1279-6562
Fernández-Diago Adriana Marcela Universidad del Cauca. Popayán, Colombia. https://orcid.org/0000-0002-5223-6467
Sanchez-Sanchez Julian Andres Universidad de Antioquia. Medellín, Colombia. https://orcid.org/0009-0006-2126-9393
Aranda-Sierra Estefanía Andrea Universidad del Tolima. Ibagué, Colombia. https://orcid.org/0009-0000-7641-7062
Rojas-Torres Laura Daniela Universidad Javeriana. Bogotá, Colombia. https://orcid.org/0009-0009-3331-8764
Toro-Torres Luisa Fernanda Universidad Nacional de Colombia. Bogotá, Colombia. https://orcid.org/0009-0006-6248-5252

Palabras clave:

Granulomatosis con poliangeítis. Otitis media. Enfermedades de la nariz. Enfermedades de la piel

Resumen

DOI: https://doi.org/10.46296/gt.v9i18.0403

Resumen

Se completó una revisión de alcance (scoping review) sobre la granulomatosis con poliangeítis con compromiso otológico, nasal y cutáneo, centrada en los escenarios en los que la otitis persistente del adulto no correspondió a una infección primaria, sino a inflamación granulomatosa y vasculítica. La búsqueda se efectuó en PubMed/MEDLINE, Scopus y ScienceDirect/Elsevier hasta abril de 2026. La síntesis clínica incluyó 55 publicaciones entre guías, ensayos, revisiones sistemáticas, cohortes, series clínicas y trabajos radiológicos o histopatológicos pertinentes. La evidencia mostró que la otitis media refractaria, la hipoacusia bilateral o rápidamente progresiva, la parálisis facial, las costras o el sangrado nasal y las lesiones cutáneas purpúricas o ulceradas configuraron un fenotipo de alarma. La seronegatividad inicial y el rendimiento variable de las biopsias, sobre todo en enfermedad localizada, explicaron parte de los retrasos diagnósticos. La literatura respaldó una evaluación clínica, audiológica, radiológica, serológica e histopatológica integrada, seguida de inmunosupresión temprana cuando la probabilidad clínica fue alta y la infección se descartó razonablemente. La cirugía quedó reservada para drenaje, obtención de tejido, complicaciones o reconstrucción durante la remisión. El reconocimiento de la otitis no infecciosa redujo la repetición de antibióticos y procedimientos locales ineficaces, y permitió disminuir el riesgo de daño auditivo, neurológico y sistémico irreversible.

Palabras claves: Granulomatosis con poliangeítis. Otitis media. Enfermedades de la nariz. Enfermedades de la piel.

Abstract

A scoping review was completed on granulomatosis with polyangiitis involving the ear, nose, and skin, focusing on scenarios in which persistent adult otitis did not represent a primary infection but granulomatous and vasculitic inflammation. PubMed/MEDLINE, Scopus, and ScienceDirect/Elsevier were searched through April 2026. The clinical synthesis comprised 55 publications, including guidelines, trials, systematic reviews, cohorts, clinical series, and relevant radiologic or histopathologic studies. The evidence showed that refractory otitis media, bilateral or rapidly progressive hearing loss, facial palsy, nasal crusting or bleeding, and purpuric or ulcerative skin lesions formed a warning phenotype. Initial seronegativity and the variable yield of biopsies, particularly in localized disease, explained part of the diagnostic delay. The literature supported integrated clinical, audiologic, radiologic, serologic, and histopathologic assessment, followed by early immunosuppression when clinical probability was high and infection had been reasonably excluded. Surgery was reserved for drainage, tissue sampling, complications, or reconstruction during remission. Recognizing noninfectious otitis reduced repeated ineffective antibiotic courses and local procedures and lowered the risk of irreversible auditory, neurologic, and systemic injury.

Keywords: Granulomatosis with Polyangiitis. Otitis Media. Nose Diseases. Skin Diseases.

Información del manuscrito:
Fecha de recepción: 14 de mayo de 2026.
Fecha de aceptación: 20 de julio de 2026.
Fecha de publicación: 27 de agosto de 2026.

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Citas

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