Subglottic stenosis in granulomatosis with polyangiitis (Wegener's granulomatosis): Report of 4 cases

Abstract

Introduction: Subglottic stenosis (SGS) in granulomatosis with polyangiitis (GPA) may result from active disease or from chronic recurrent inflammation. The objective of the study was to describe the clinical features and treatment of patients with subglottic stenosis.

Methods: We retrospectively reviewed the medical records of all patients with SGS due to GPA diagnosed at Rheumatology deparment between January 2000 and June 2015.

Results: We present 4 cases of SGS at our department during a period of 15 years. The interval between the presentation of the GPA and SGS varied between 2 and 144 months. The leading symptoms of SGS were dyspnoea on exertion and stridor. Three patients presented SGS without evidence of systemic activity. Two patients presented SGS grade i and received tracheal dilatation; two recurred and three needed a tracheostomy due to severe airway-limiting stenosis.

Conclusion: SGS presents high morbidity. Even though subglottic dilatation provides symptomatic relief, recurrences may present. Severe airway-limiting stenosis often requires tracheostomy.

Keywords: Estenosis subglótica; Granulomatosis con poliangitis; Granulomatosis de Wegener; Granulomatosis with polyangiitis; Subglottic stenosis; Wegener's granulomatosis.