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Laryngeal involvement in systemic lupus erythematosus.

A D Teitel1, C R MacKenzie, R Stern

  • 1Department of Medicine and Rheumatology, Hospital for Special Surgery, New York, NY 10021.

Seminars in Arthritis and Rheumatism
|December 1, 1992
PubMed
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Systemic lupus erythematosus (SLE) can affect the larynx, causing symptoms from hoarseness to airway obstruction. Corticosteroids often resolve these laryngeal manifestations in SLE patients.

Area of Science:

  • Rheumatology
  • Otolaryngology
  • Pulmonology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Laryngeal involvement in SLE, though uncommon, can present with a spectrum of pathologies, impacting the upper airway.

Observation:

  • This report details four cases of laryngeal involvement in SLE, reviewing 97 patients.
  • Observed manifestations included laryngeal edema (28%) and vocal cord paralysis (11%).
  • Symptoms like hoarseness, dyspnea, and vocal cord paralysis were common.

Findings:

  • The majority of laryngeal SLE symptoms resolved with corticosteroid therapy.
  • Less frequent causes included subglottic stenosis, rheumatoid nodules, and necrotizing vasculitis.

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  • Clinical presentation varied from asymptomatic to life-threatening airway compromise.

    • Implications:

    • Laryngeal involvement in SLE presents a diagnostic and therapeutic challenge due to its variable course and multiple potential causes.
    • Early recognition and management are crucial for preventing severe upper airway compromise.
    • This highlights the importance of considering laryngeal evaluation in SLE patients with relevant symptoms.