{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:40:58Z","timestamp":1760060458194,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82401338"],"award-info":[{"award-number":["82401338"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Granulomatosis with polyangiitis (GPA), an immune-mediated systemic small-vessel vasculitis affecting the upper\/lower respiratory tracts and kidneys, frequently presents with non-specific nasal symptoms that lead to misdiagnosis. Case Presentation: We report a case of a 55-year-old female with GPA complicated by Bartter syndrome. She presented with one month of left nasal congestion, rhinorrhea, epistaxis, and headache. Initial diagnosis was acute sinusitis. Computed tomography (CT) revealed left maxillary and ethmoid sinus inflammation with bone destruction, while metagenomic next-generation sequencing (mNGS) suggested conventional bacterial infection. Postoperative pathology demonstrated chronic mucosal inflammation with lymphoid tissue hyperplasia. GPA was ultimately diagnosed based on PR3-ANCA seropositivity and chest CT findings of cavitary pulmonary nodules. Postoperatively, severe hypokalemia and hypomagnesemia secondary to Bartter syndrome emerged. Following electrolyte correction, induction therapy with glucocorticoids and cyclophosphamide was initiated. Conclusions: This case underscores that GPA\u2019s head and neck manifestations are frequently misdiagnosed as infections or malignancies. Early diagnosis requires vigilance for GPA \u2018red flags\u2019, such as refractory nasal symptoms to conventional therapy (e.g., bloody rhinorrhea), characteristic CT findings (e.g., sinus opacification without ostiomeatal complex obstruction), and nasal endoscopy findings (e.g., ulcers\/crusting). Otolaryngologists play a pivotal role in recognizing early disease onset and initiating timely treatment.<\/jats:p>","DOI":"10.3390\/diagnostics15172218","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T14:02:46Z","timestamp":1756735366000},"page":"2218","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Unveiling of the Misdiagnosis of Granulomatosis with Polyangiitis as Acute Sinusitis: A Case Report"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6134-5630","authenticated-orcid":false,"given":"Qi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangyiyi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhewei","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guokang","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6682-6575","authenticated-orcid":false,"given":"Jing","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.37715","article-title":"2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides","volume":"65","author":"Jennette","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/0394632015617063","article-title":"Clinic manifestations in granulomatosis with polyangiitis","volume":"29","author":"Greco","year":"2016","journal-title":"Int. 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