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危及生命的肉芽肿性多血管炎所致声门下狭窄:病例报告。

Life-Threatening Subglottic Stenosis of Granulomatosis with Polyangiitis: A Case Report.

机构信息

Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea.

Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Korea.

出版信息

Medicina (Kaunas). 2021 Apr 27;57(5):423. doi: 10.3390/medicina57050423.

Abstract

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by necrotizing granulomatous inflammation. Subglottic stenosis, which is defined as narrowing of the airway below the vocal cords, has a frequency of 16-23% in GPA. Herein, we present the case of a 39-year-old woman with subglottic stenosis manifesting as life-threatening GPA, which was recurrent under systemic immunosuppressive therapy. The patient underwent an emergency tracheostomy, intratracheal intervention, such as carbon dioxide (CO) laser surgery and intralesional steroid injection via laryngomicroscopic surgery, and laryngotracheal resection with remodeling. Severe subglottic stenosis treatment requires active intratracheal intervention, surgery, and systemic immunosuppressive therapy.

摘要

肉芽肿性多血管炎(GPA)是一种自身免疫性疾病,其特征为坏死性肉芽肿性炎症。声门下狭窄是 GPA 的一种表现,定义为声带以下气道狭窄,其发生率为 16-23%。本文报告了一例 39 岁女性患者,因危及生命的 GPA 而出现声门下狭窄,在全身免疫抑制治疗下反复发作。患者接受了紧急气管切开术、气管内介入治疗,如二氧化碳(CO)激光手术和经喉镜手术的腔内类固醇注射,以及喉气管切除和重建。严重的声门下狭窄需要积极的气管内介入、手术和全身免疫抑制治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85d/8145547/24970b7011ee/medicina-57-00423-g001.jpg

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