Wegener's granulomatosis of the pediatric airway: a case demonstrating a conservative management approach.
OBJECTIVE
Subglottic stenosis is found in 10% to 20% of patients with Wegener's granulomatosis, and at times, it may be the only indication of disease. This is particularly a problem in childhood-onset Wegener's granulomatosis, which is complicated 5 times more by subglottic and tracheal stenosis than in adult-onset disease. Because this is a rare disease that is often misdiagnosed as reactive airway disease in childhood, the discovery of subglottic stenosis is delayed until much of the chronic damage has already been done. This report discusses the diagnosis and management of a 12-year-old male with a severe, actively inflamed subglottis and trachea because of Wegener's granulomatosis.


METHODS
This study uses a retrospective case review.


RESULTS
The study shows a successful symptomatic medical treatment of subglottic stenosis with resolution of tracheal inflammation and subglottic stenosis.


CONCLUSIONS
Treatment of an actively inflamed trachea with subglottic stenosis because of Wegener's granulomatosis should focus on medical therapy, including steroids, before making attempts at surgical intervention.
White
Jeremy B
JB
Division of Otolaryngology, The George Washington University School of Medicine, Washington, DC, USA.
Shah
Rahul K
RK
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007829:Laryngostenosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents