Use of anticytoplasmic autoantibodies in the diagnosis of Wegener's granulomatosis with subglottic stenosis.

Subglottic stenosis is one of the lesser known manifestations of Wegener's granulomatosis and poses great difficulty in confirming the diagnosis. We present the use of the anticytoplasmic autoantibodies (ACPA) blood test, which has been shown to be highly specific for Wegener's granulomatosis, for corroboration of Wegener's granulomatosis in a patient with subglottic stenosis for whom tissue biopsies were nondiagnostic. The ACPA test and the presentation, diagnosis, and management of subglottic stenosis due to Wegener's granulomatosis are discussed. Otolaryngologists must be aware of the varied manifestations of Wegener's granulomatosis and the availability of the ACPA blood test as an aid in confirming the diagnosis.