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Cricoarytenoiditis as a cause of acute airway obstruction in children
1Department of Emergency Medicine, Minneapolis Children's Medical Center, Minnesota.
Insights
Juvenile rheumatoid arthritis can affect the cricoarytenoid joint in children, causing severe respiratory distress. Early diagnosis and treatment with steroids are crucial for managing this rare complication.
Area of Science:
- Pediatric Rheumatology
- Pediatric Pulmonology
- Pediatric Critical Care
Background:
- Juvenile rheumatoid arthritis (JRA) is a chronic autoimmune disease affecting children.
- Arthritis of the cricoarytenoid joint is a rare but serious complication, more commonly seen in adults.
- Respiratory distress in children with JRA necessitates prompt investigation of potential airway involvement.
Observation:
- A 4-1/2-year-old girl with a year-long history of JRA presented with acute, severe respiratory distress.
- Endotracheal intubation was required due to the critical airway compromise.
- Physical examination and diagnostic workup revealed arthritis of the cricoarytenoid joint.
Findings:
- The patient's respiratory distress resolved following endotracheal intubation and administration of high-dose corticosteroids.
- This case represents the third reported instance of cricoarytenoid joint arthritis in a pediatric patient.
- The successful management highlights the efficacy of aggressive treatment in this rare condition.
Implications:
- This case underscores the importance of considering cricoarytenoid joint involvement in pediatric patients with JRA presenting with respiratory symptoms.
- Early recognition and intervention can prevent severe morbidity and mortality associated with airway compromise.
- Further research into the prevalence and optimal management strategies for pediatric cricoarytenoid arthritis is warranted.
Abstract:
A 4-1/2-year-old girl with a one-year history of juvenile rheumatoid arthritis was admitted with severe respiratory distress requiring endotracheal intubation. Arthritis of the cricoarytenoid joint was diagnosed and she responded well to intubation and high-dose steroids. Although well described in adults, this is only the third case report of a child afflicted with arthritis of the cricoarytenoid joint.