Granulomatosis with polyangiitis causing subglottic stenosis-two cases and their management

Area of Science:

• Rheumatology
• Otolaryngology
• Pulmonology

Background:

• Granulomatosis with polyangiitis (GPA) is an autoimmune vasculitis affecting small to medium blood vessels and causing granulomatous respiratory lesions.
• Approximately 92% of GPA patients are antineutrophilic cytoplasmic antibodies (ANCA) positive, often presenting in early adulthood, particularly in winter.
• Ear, nose, and throat symptoms, including nasal congestion and septal perforation, occur in 70% of GPA cases.

Observation:

• Airway lesions in GPA can lead to subglottic stenosis, causing significant airway obstruction.
• Subglottic stenosis management in GPA is complex, requiring careful consideration of medical and surgical options.
• Two cases of GPA complicated by airway obstruction due to subglottic stenosis are presented.

Findings:

• The presented cases highlight the challenges in managing GPA-induced subglottic stenosis.
• Individualized treatment strategies balancing risks and benefits are crucial for effective patient outcomes.
• This study underscores the importance of recognizing and addressing airway complications in GPA.

Implications:

• Improved understanding of GPA's impact on the airway can lead to earlier diagnosis and intervention.
• Tailored management approaches for subglottic stenosis in GPA may improve patient prognosis.
• Further research into optimal treatment modalities for GPA-related airway obstruction is warranted.