title: Morbidity and mortality associated with subglottic laryngotracheal stenosis in granulomatosis with polyangiitis (Wegener's granulomatosis): a single-centre experience in the United Kingdom.
abstract: OBJECTIVE
  We aimed to determine the prevalence of symptomatic subglottic laryngotracheal stenosis in patients with granulomatosis with polyangiitis (Wegener's granulomatosis); we also wanted to characterise the clinical outcomes and surgical interventions required, and the relapse rate in our cohort.
  
  
  METHODS
  We undertook a retrospective clinical review of all granulomatosis with polyangiitis patients with symptomatic subglottic laryngotracheal stenosis attending St Thomas' Hospital, London, United Kingdom.
  
  
  RESULTS
  Symptomatic subglottic laryngotracheal stenosis developed in 16 per cent of granulomatosis with polyangiitis patients attending our clinic. The median age of patients at diagnosis was 44 years (range: 34-81 years); 78 per cent of those presenting with subglottic laryngotracheal stenosis were women and 22 per cent were men. All patients were white; 67 per cent of patients were proteinase 3-antineutrophil cytoplasmic antibody-positive and 67 per cent developed relapsing disease requiring repeated surgical intervention. Subglottic laryngotracheal stenosis relapse was not associated with active systemic vasculitis elsewhere.
  
  
  CONCLUSIONS
  Subglottic laryngotracheal stenosis is an uncommon but significant complication of granulomatosis with polyangiitis. Management of subglottic laryngotracheal stenosis requires a multi-disciplinary approach, with both rheumatological and otolaryngological expertise involved, given the relapsing nature of the disease.
authors.affiliation: Louise Coote Lupus Unit,St Thomas' Hospital,London,UK.
authors.forename: N P
authors.initials: NP
authors.lastname: Jordan
authors.affiliation: Department of Radiology,St Thomas' Hospital,London,UK.
authors.forename: H
authors.initials: H
authors.lastname: Verma
authors.affiliation: Department of Radiology,St Thomas' Hospital,London,UK.
authors.forename: A
authors.initials: A
authors.lastname: Siddiqui
authors.affiliation: ENT Department,St Thomas' Hospital,London,UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Morrison
authors.affiliation: Louise Coote Lupus Unit,St Thomas' Hospital,London,UK.
authors.forename: D P
authors.initials: DP
authors.lastname: D'Cruz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D007829:Laryngostenosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D008131:London; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D006113:United Kingdom