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Granulomatosis with polyangiitis-associated acute subglottic stenosis in a 13-year-old boy: a case report

Giuliana Geng-Ramos1, Nina Nami2, David J Mener3

  • 1Division of Pediatric Anesthesia, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD, USA. ggengra1@jhmi.edu.

Paediatric Anaesthesia
|August 9, 2016
PubMed

Insights

This case study details the anesthetic management of a child with granulomatosis with polyangiitis presenting with subglottic stenosis and acute respiratory distress.

Area of Science:

  • Pediatric Anesthesiology
  • Rheumatology
  • Pulmonology

Background:

  • Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis that can affect the upper and lower respiratory tracts.
  • Subglottic stenosis is a serious complication of GPA, potentially leading to airway obstruction and respiratory failure.
  • Anesthetic management in pediatric patients with GPA and subglottic stenosis requires careful planning to mitigate risks.

Observation:

  • A pediatric patient with known GPA presented with acute respiratory distress.
  • The respiratory distress was attributed to severe subglottic stenosis.
  • The case highlights the challenges in managing the airway in such patients.

Findings:

  • Successful anesthetic management was achieved for a pediatric patient with GPA and subglottic stenosis.
  • The anesthetic approach focused on securing the airway while minimizing trauma and exacerbation of stenosis.
  • Potential complications, including bleeding and airway injury, were carefully monitored and managed.

Implications:

  • This case underscores the importance of a multidisciplinary approach in managing pediatric patients with GPA and airway compromise.
  • It provides insights into safe anesthetic techniques for complex airway scenarios in pediatric rheumatology patients.
  • Early recognition and intervention for subglottic stenosis in GPA are crucial for favorable outcomes.

Keywords:
anesthesiadifficult airwaygranulomatosispediatricsubglottic stenosis

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