Presentation, Diagnosis and Management of Subglottic and Tracheal Stenosis During Systemic Inflammatory Diseases

Chest. 2021 Jul 26:S0012-3692(21)01391-X. doi: 10.1016/j.chest.2021.07.037. Online ahead of print.ABSTRACTBACKGROUND: Subglottic (SGS) and tracheal stenoses (TS) are characterized by a narrowing of the airways. We aimed to describe characteristics and prognosis of nontraumatic and nontumoral SGS or TS.RESEARCH QUESTION: What are the inflammatory etiologies of subglottic and tracheal stenosis and what are their characteristics and prognosis?STUDY DESIGN AND METHODS: We conducted a multicenter observational retrospective study of patients with neither traumatic nor tumoral SGS or TS.RESULTS: Eighty-one patients were included, 33 (41%) with granulomatosis with polyangiitis (GPA) and 21 (26%) with relapsing polychondritis (RP). GPA-related stenoses showed circumferential subglottic narrowing in 85% of cases, without calcifications. In contrast, RP-related stenoses displayed anterior involvement in 76%, in a longer distance from vocal cords (4 cm), with calcifications in 62% and extension to bronchi in 86%. Other diagnoses included bullous dermatoses (n=3), amyloidosis (n=3), sarcoidosis (n=2) and Crohn's disease (n=2), while remaining stenoses (n=15) were idiopathic. SGS/TS was the initial manifestation of the disease in 66% of cases, with a median interval from stenosis to disease diagnosis of 12 months (IQR 0-48). Despite the use of glucocorticoids in 80%, combined with methotrexate in 49%, endoscopic procedures were required in 68% of patients. Relapses of stenoses occurred in...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research