scholarly journals Wegener’s granulomatosis: surgical repair of severe subglottic stenosis

2020 ◽  
Vol 12 (4) ◽  
pp. 119-120
Author(s):  
Isabel Costa ◽  
António Lim ◽  
Cátia Azevedo ◽  
Fernando Mar ◽  
Berta Rodrigues ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Wegener’S Granulomatosis ◽  
Granulomatosis With Polyangiitis ◽  
Surgical Repair ◽  
Balloon Dilation ◽  
Wegener's Granulomatosis ◽  
Subglottic Stenosis ◽  
Transoral Laser Microsurgery ◽  
Atypical Form ◽  
Life Threatening

Laryngeal and subglottic stenosis are present in about 20% of patients with granulomatosis with polyangiitis. This atypical form of the disease can be severe and life-threatening. In what concerns to treatment, subglottic lesions are less responsive to conventional systemic therapy and interventional and surgical procedures should be considered. The authors present a case of a 30-year-old woman with diagnosis of Wegener’s granulomatosis who presented to our department with dyspnea and stridor due to a severe subglottic stenosis, requiring an emergent tracheostomy. The obstructive defect was electively and effectively repaired through a transoral laser microsurgery using local application prednisolone and mitomycin C followed by balloon dilation.

scholarly journals Ruptured arterial aneurysm in Wegener’s granulomatosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
A. Gravos ◽  
K. Katsifa ◽  
P. Tselioti ◽  
V. Grammatikopoulou ◽  
K. Sakellaridis ◽  
...  
Keyword(s):  
Wegener’S Granulomatosis ◽  
Granulomatosis With Polyangiitis ◽  
Rare Complication ◽  
Supportive Therapy ◽  
Wegener's Granulomatosis ◽  
Multiple Organ ◽  
Ruptured Aneurysm ◽  
Arterial Aneurysm ◽  
Life Threatening ◽  
Old Greek

Abstract Background Aneurysm formation is a possible, but rare, complication of granulomatosis with polyangiitis, known as Wegener’s granulomatosis. Urgent diagnosis and therapy is very important because a ruptured aneurysm could be life threatening. Case presentation We, therefore, present the case of a 63-year-old Greek man who was diagnosed with granulomatosis with polyangiitis and retroperitoneal hematoma due to ruptured aneurysm in renal artery and upper pancreaticoduodenal artery. His clinical course was complicated by acute renal failure and acute respiratory failure due to alveolar hemorrhage. Emergency coil embolization was performed. Postembolization recovery was uneventful; no bleeding occurred. The patient underwent mechanical ventilation and continuous veno-venous hemofiltration and received combined immunosuppression and supportive therapy, but eventually died 30 days after admission to hospital from severe septic shock and multiple organ failure. Conclusion Endovascular treatment is the therapy of choice, especially for patients with ruptured aneurysms that are hemodynamically stable. Early diagnosis is very important, as urgent embolization and early initiation of immunosuppression therapy are the treatment of choice.

Subglottic Stenosis in Granulomatosis With Polyangiitis (Wegener's Granulomatosis): Report of 4 Cases

2016 ◽  
Vol 12 (5) ◽  
pp. 267-273
Author(s):  
Gabriel Horta-Baas ◽  
María Fernanda Hernández-Cabrera ◽  
Rocío Catana ◽  
Mario Pérez-Cristóbal ◽  
Leonor Adriana Barile-Fabris
Keyword(s):  
Wegener’S Granulomatosis ◽  
Granulomatosis With Polyangiitis ◽  
Wegener's Granulomatosis ◽  
Subglottic Stenosis

scholarly journals Life-Threatening Subglottic Stenosis of Granulomatosis with Polyangiitis: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 423
Author(s):  
Jin An ◽  
Jae-Won Song
Keyword(s):  
Immunosuppressive Therapy ◽  
Granulomatosis With Polyangiitis ◽  
Granulomatous Inflammation ◽  
Subglottic Stenosis ◽  
Emergency Tracheostomy ◽  
Intralesional Steroid ◽  
Intralesional Steroid Injection ◽  
Life Threatening ◽  
Carbon Dioxide Co2 ◽  
Laryngotracheal Resection

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by necrotizing granulomatous inflammation. Subglottic stenosis, which is defined as narrowing of the airway below the vocal cords, has a frequency of 16–23% in GPA. Herein, we present the case of a 39-year-old woman with subglottic stenosis manifesting as life-threatening GPA, which was recurrent under systemic immunosuppressive therapy. The patient underwent an emergency tracheostomy, intratracheal intervention, such as carbon dioxide (CO2) laser surgery and intralesional steroid injection via laryngomicroscopic surgery, and laryngotracheal resection with remodeling. Severe subglottic stenosis treatment requires active intratracheal intervention, surgery, and systemic immunosuppressive therapy.

Morbidity and mortality associated with subglottic laryngotracheal stenosis in granulomatosis with polyangiitis (Wegener's granulomatosis): a single-centre experience in the United Kingdom

2014 ◽  
Vol 128 (9) ◽  
pp. 831-837 ◽  
Author(s):  
N P Jordan ◽  
H Verma ◽  
A Siddiqui ◽  
G A Morrison ◽  
D P D'Cruz
Keyword(s):  
United Kingdom ◽  
Wegener’S Granulomatosis ◽  
Granulomatosis With Polyangiitis ◽  
Systemic Vasculitis ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Wegener's Granulomatosis ◽  
Laryngotracheal Stenosis ◽  
Surgical Interventions ◽  
The United Kingdom ◽  
Single Centre Experience

AbstractObjectives:We aimed to determine the prevalence of symptomatic subglottic laryngotracheal stenosis in patients with granulomatosis with polyangiitis (Wegener's granulomatosis); we also wanted to characterise the clinical outcomes and surgical interventions required, and the relapse rate in our cohort.Methods:We undertook a retrospective clinical review of all granulomatosis with polyangiitis patients with symptomatic subglottic laryngotracheal stenosis attending St Thomas' Hospital, London, United Kingdom.Results:Symptomatic subglottic laryngotracheal stenosis developed in 16 per cent of granulomatosis with polyangiitis patients attending our clinic. The median age of patients at diagnosis was 44 years (range: 34–81 years); 78 per cent of those presenting with subglottic laryngotracheal stenosis were women and 22 per cent were men. All patients were white; 67 per cent of patients were proteinase 3-antineutrophil cytoplasmic antibody-positive and 67 per cent developed relapsing disease requiring repeated surgical intervention. Subglottic laryngotracheal stenosis relapse was not associated with active systemic vasculitis elsewhere.Conclusion:Subglottic laryngotracheal stenosis is an uncommon but significant complication of granulomatosis with polyangiitis. Management of subglottic laryngotracheal stenosis requires a multi-disciplinary approach, with both rheumatological and otolaryngological expertise involved, given the relapsing nature of the disease.

Endoscopic Management of Severe Subglottic Stenosis in Wegener's Granulomatosis

2000 ◽  
Vol 19 (4) ◽  
pp. 315-317 ◽  
Author(s):  
I. Stappaerts ◽  
C. Van Laer ◽  
K. Deschepper ◽  
P. Van de Heyning ◽  
P. Vermeire
Keyword(s):  
Wegener’S Granulomatosis ◽  
Wegener's Granulomatosis ◽  
Subglottic Stenosis ◽  
Endoscopic Management
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