Coutinho Mona-Lisa, Portela E Silva Ricardo, Postiga André, Almeida Valentina
Anesthesiology, Unidade Local de Saúde de Coimbra, Coimbra, PRT.
Cureus. 2024 Dec 8;16(12):e75307. doi: 10.7759/cureus.75307. eCollection 2024 Dec.
Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis that can involve the respiratory tract and lead to severe airway complications. We present a 61-year-old female with an undiagnosed GPA who experienced severe airway obstruction and rapid deterioration during a flexible bronchoscopy. Severe glottic edema and reduced vocal cord mobility resulted in a challenging airway and rapid desaturation, and ultimately led to cardiac arrest. This case highlights the importance of considering GPA in the differential diagnosis of patients with unexplained respiratory symptoms, even in the absence of classic clinical features. Early diagnosis, careful pre-procedural airway assessment, and experienced airway management are essential to minimize the risk of airway compromise in patients with suspected or confirmed GPA.
肉芽肿性多血管炎（GPA）是一种罕见的系统性血管炎，可累及呼吸道并导致严重的气道并发症。我们报告了一名61岁未确诊GPA的女性患者，她在一次可弯曲支气管镜检查期间出现严重气道阻塞和病情迅速恶化。严重的声门水肿和声带动度降低导致气道处理困难和迅速出现低氧血症，最终导致心脏骤停。该病例强调了在不明原因呼吸道症状患者的鉴别诊断中考虑GPA的重要性，即使没有典型临床特征。早期诊断、仔细的术前气道评估以及经验丰富的气道管理对于将疑似或确诊GPA患者的气道受损风险降至最低至关重要。
