Vocal cord lesions in representative autoimmune diseases

Area of Science:

• Rheumatology
• Otolaryngology
• Immunology

Background:

• Autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) can manifest with extra-articular involvements.
• Vocal cord lesions are a potential, though less commonly reported, manifestation in patients with autoimmune conditions.

Purpose of the Study:

• To delineate the clinical characteristics of vocal cord lesions in patients diagnosed with SLE and RA.
• To compare the prevalence and features of vocal cord lesions between SLE and RA patients and matched controls.

Main Methods:

• A retrospective case-control study involving 31 patients with SLE/RA and vocal cord lesions (SLE/RA-VC group) and 93 age/sex-matched SLE/RA patients without vocal cord lesions (SLE/RA-nVC group).
• Clinical data, including lesion type, laterality, disease activity indices, and treatment outcomes, were extracted from medical records for comparative analysis.

Main Results:

• Vocal cord paralysis (38.7%) and vocal cord mass (45.2%) were the predominant lesions. Unilateral lesions were more frequent (67.8%).
• SLE patients with vocal cord lesions exhibited higher disease activity (SLEDAI-2K) compared to controls (p=0.041). Vocal cord bamboo node lesions were noted as an initial manifestation in two SLE patients.
• RA patients with vocal cord lesions had less pulmonary interstitial disease (p=0.017) and lower CRP levels (p=0.006) than controls. Treatment with glucocorticoids and immunosuppressants led to improvement in 45.2% of patients.

Conclusions:

• Vocal cord lesions in SLE/RA patients represent a systemic manifestation requiring appropriate management.
• A correlation between vocal cord lesion occurrence and disease activity was observed in SLE, but not in RA.
• Glucocorticoids and immunosuppressants appear to be effective therapeutic options for vocal cord lesions in SLE/RA.