Symmetric polyarthritis as an initial symptom in granulomatosis with polyangiitis: A report of six cases and review of the literature

Abstract

Granulomatosis with polyangiitis (GPA) is a primary systemic vasculitis characterized by granuloma-tous inflammation. Arthritis in GPA is most commonly associated with large joints, particularly theknees and ankles; however, symmetrical polyarthritis of small joints has been rarely reported in lit-erature. Here, we describe retrospective analysis of six patients with GPA showing initial symptom ofsymmetrical polyarthritis who were followed-up by three different rheumatology departments. Malesex, anti-cyclic citrulinated peptide negativity, and early arthritis period are important clues for GPA.