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The Liverpool experience: The role of immunosuppression in treating vasculitic subglottic stenosis
- Source :
- Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-LaryngologyCervico-Facial SurgeryREFERENCES. 47(2)
- Publication Year :
- 2021
-
Abstract
- Five Key Points • Subglottic stenosis (SGS) is the commonest tracheobronchial manifestation of granulomatosis with polyangiitis (GPA), with early recognition and treatment key to preventing its vasculitic progression and fibrosis. • Previous studies have shown SGS to be the first feature of GPA in 4% of cases. It is not uncommon to see negative biochemical (10% ANCA negative) and negative histological biopsies (77% of head and neck specimens are negative). • Our management strategy emphasized rapid SGS-GPA treatment with limited surgical manipulation of the airway and systemic immunosuppression (IS) to prevent evolution of SGS & concurrent systemic vasculitic relapse. • In our study early multi-disciplinary team involvement to deliver induction IS in the presence of active SGS-GPA led to a procedure free interval (PFI) of 31.3 months. This is a significant increase compared to other published studies. • Nineteen percent (4/21) of the cohort did not require any surgical input following induction IS.
- Subjects :
- Adult
Male
medicine.medical_specialty
Subglottic stenosis
medicine.medical_treatment
Free interval
Cohort Studies
Young Adult
stomatognathic system
Fibrosis
medicine
Humans
Anti-neutrophil cytoplasmic antibody
Aged
Retrospective Studies
Immunosuppression Therapy
business.industry
Granulomatosis with Polyangiitis
Immunosuppression
Laryngostenosis
Middle Aged
medicine.disease
Surgery
Otorhinolaryngology
Cohort
Female
Granulomatosis with polyangiitis
business
Airway
Subjects
Details
- ISSN :
- 17494486
- Volume :
- 47
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-LaryngologyCervico-Facial SurgeryREFERENCES
- Accession number :
- edsair.doi.dedup.....add0b9ab19ca5d4e02d5941feb49e96c