A case of Wegener granulomatosis with a pattern of upper respiratory stenosis in respiratory function test by subglottic stenosis
Go Tsukuya Tsutomu Hamada Motokawa Ikuyo Takuya Samukawa Inoue Hiromasa
Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
The case is a 23-year-old woman with a chief complaint of dyspnea, wheeze, and dry cough. In May 2004, she had left otorrhea and was both hard of hearing and hoarse. She saw a close otorhinolaryngology, and was pointed out filling granulomatous formation in her left auris media. A biopsy of that showed neutrophil-dominant granuloma, which led the diagnosis to eosinophilic otitis. Since then, drainage of her left auris media and steroid injections into the granuloma have been done. On the other hand, she also revealed subglottic stenosis, diagnosed as idiopathic subglottic stenosis, and since then has started oral prednisolone 2 mg/day. In February 2009, she had dyspnea on effort, wheeze, and dry cough. She was found to have multiple nodules in both lung fields in a chest X-ray by a nearby doctor. A CT-needle-aspiration biopsy was done in our hospital, and she diagnosed as Wegener granulomatosis in pathological and clinical findings. In remission induction therapy, the complaint was rapidly improved, but subglottic stenosis remained. We experienced a case of WG needed for 5 years until the final diagnosis and made no response to the subglottic stenosis in remission induction therapy.
Subglottic stenosis Wegener granulomatosis [Granulomatosis with polyangiitis (Wegener's)] The pattern of upper respiratory stenosis
Received 28 Dec 2011 / Accepted 6 Jul 2012
AJRS, 2(2): 107-113, 2013