Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-29T20:21:11.675Z Has data issue: false hasContentIssue false
  • English
  • Français

Wegener's granulomatosis, subglottic stenosis and antineutrophil cytoplasm antibodies.

Published online by Cambridge University Press:  29 June 2007

T. J. Hoare ,
D. Jayne ,
P. Rhys Evans ,
C. B. Croft  and
D. J. Howard
T. J. Hoare*
Affiliation:
Royal National Throat Nose and Ear Hospital, Grays Inn Road, London WC1X8DA
D. Jayne
Affiliation:
University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ
P. Rhys Evans
Affiliation:
Royal Marsden Hospital, Fulham Road, London SW3
C. B. Croft
Affiliation:
Royal National Throat Nose and Ear Hospital, Grays Inn Road, London WC1X8DA
D. J. Howard
Affiliation:
Royal National Throat Nose and Ear Hospital, Grays Inn Road, London WC1X8DA
*
Mr. T. J. Hoare, FRCS, ENT Registrar, Dudley Road Hospital, Dudley Road, Birmingham
Get access Rights & Permissions [Opens in a new window]

Abstract

Wegener's granulomatosis is difficult to diagnose, especially when the presentation is unusual, restricted to an isolated region. We report four cases of recurrent subglottic stenosis posing difficulty in diagnosis. In each case the finding of anti-neutrophil cytoplasm antibodies (ANCA) strongly suggested an underlying vasculitic pathology, Wegener's granulomatosis. We discuss reasons for the difficulty in diagnosis in the past, the possible role of the ANCA assay in such patients, and suggest it should be more widely used in the future.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 12 , December 1989 , pp. 1187 - 1191
Copyright
Copyright © JLO (1984) Limited 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arauz, J. C. and Fonseca, R. (1982). Wegener's granulomatosis appearing initially in the trachea. Annals of Otology, Rhinology and Laryngology, 91: 593–594.CrossRefGoogle ScholarPubMed
Atkins, J. P. and Eisman, S. H. (1959). Wegener's granulomatosis. Annals of Otology, Rhinology and Laryngology, 68: 524–547.CrossRefGoogle ScholarPubMed
Brown, H. A. and Woolner, L. B. (1960). Findings referable to the upper part of the respiratory tract in Wegener's granulomatosis. Annals of Otology, Rhinology and Laryngology, 69: 810–829.CrossRefGoogle Scholar
Carrington, C. B. and Liebow, A. A. (1966). Limited forms of angiitis and granulomatosis of Wegener's type. American Journal of Medicine, 41: 497–527.CrossRefGoogle ScholarPubMed
Cohen Tervaert, J. W., Goldschmeding, R., Hene, R. J. and Kallenberg, C. G. M. (1989). Neutrophil cytoplasmic autoantibodies and Wegener's granulomatosis. Lancet, 1: 270.Google Scholar
Davies, D. J., Moran, J. E., Niall, J. F. and Ryan, G. B. (1982). Segmental necrotising glomerulonephritis with anti-neutrophil antibody: possible arbovirus aetiology. British Medical Journal 285: 606–607.CrossRefGoogle Scholar
Djalilian, M., McDonald, T. J., Devine, K. D. and Weiland, L. H. (1975). Non-traumatic subglottic stenosis. Annals of Otology, Rhinology and Laryngology, 84: 757–763.CrossRefGoogle Scholar
Fauci, A. S., Haynes, B. F., Katz, P. and Wolff, S. M. (1983). Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Annals of Internal Medicine, 98: 76–85.CrossRefGoogle Scholar
Friedmann, I. and Ferlito, A. (1988). Granulomas and neoplasms of the larynx. Churchill Livingstone, Edinburgh: 67–72.Google Scholar
Gans, R. O. B., Goldschmeding, R., Donker, A. J. M., Hoorntje, S. J., Kuizinga, M. C., Cohen Tervaert, J. W., Kallenberg, C. G. M. and Kr VD Borne, A. E. G. (1989). Neutrophil cytoplasmic autoantibodies and Wegener's granulomatosis. Lancet, 1: 269–270.CrossRefGoogle Scholar
Gross, W. L., Ludemann, G., Kiefer, G. and Lehmann, H. (1986). Anticytoplasmic antibodies in Wegener's granulomatosis. Lancet, 1: 806.CrossRefGoogle ScholarPubMed
Harrington, J. and McClusky, R. (1979). Rapidly progressive renal failure seventeen months after laryngeal obstruction. New England Journal of Medicine, 24: 1378–1385.Google Scholar
Harrison, D. F. N. (1974). Non-healing granulomata of the upper respiratory tract. British Medical Journal, 4: 205–209.CrossRefGoogle ScholarPubMed
Hellman, D., Laing, T., Petri, M., Jacobs, D., Crumley, R. and Stulbarg, M. (1987). Wegener's granulomatosis: isolated involvement of the trachea and larynx. Annals of the Rheumatic Diseases, 46: 628–631.CrossRefGoogle Scholar
Hoare, T. J. and Rhys Evans, P. (1988). Anti neutrophil cytoplasmic antibody in diagnosis of recurrent subglottic stenosis. Lancet, 2: 1360.CrossRefGoogle ScholarPubMed
Illum, P. and Thorling, K. (1981). Wegener's granulomatosis: long-term results of treatment. Annals of Otology, Rhinology and Laryngology, 90: 231–235.CrossRefGoogle ScholarPubMed
Lockwood, C. M., Bakes, D., Jones, S., Whitaker, K. B., Moss, D. W. and Savage, C. O. S. (1987). Association of alkaline phosphatase with an autoantigen recognized by circulating anti-neutrophil antibodies in systemic vasculitis. Lancet, 1: 716–720.CrossRefGoogle ScholarPubMed
McDonald, T. J., Neel, H. B. and DeRemee, R. A. (1982). Wegener's granulomatosis of the subglottis and the upper portion of the trachea. Annals of Otology, Rhinology and Laryngology, 91: 588–592.CrossRefGoogle ScholarPubMed
Mains, B. (1989). Wegener's granulomatosis: false positive antineutrophil cytoplasmic antibody test. Journal of Laryngology and Otology, 103: 524–525.CrossRefGoogle Scholar
Michaels, L. (1984). Pathology of the larynx. Springer-Verlag. Berlin: 129–130.CrossRefGoogle Scholar
Rasmussen, N., Wiik, A., Hoier-Madsen, M., Borregard, N. and van der Woude, F. J. (1988). Antineutrophil cytoplasm antibodies 1988. Lancet, 1: 706–707.CrossRefGoogle ScholarPubMed
Ridley, M. G., Wolfe, C. S., Asherson, R. A. and Hughes, G. R. V. (1988). Recurrent otitis media and pulmonary infiltrates as presenting features in Wegener's granulomatosis. British Medical Journal, 297: 352–353.CrossRefGoogle ScholarPubMed
Savage, C. O. S., Tizard, J., Jayne, D. R. W., Lockwood, C. M. and Dillon, M. J. (1989). Antineutrophil cytoplasm antibodies in Kawasaki disease. Archives of Disease in Childhood, 64: 360–363.CrossRefGoogle ScholarPubMed
Savage, C. O. S., Winearls, C. G., Jones, S., Marshall, P. D. and Lockwood, C. M. (1987). Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis. Lancet, 1: 1389–1393.CrossRefGoogle ScholarPubMed
Terent, A., Wibell, L., Lindholm, C. E. and Wilbrand, H. (1980). Laryngeal granuloma in the early stages of Wegener's granulomatosis. Journal of Otorhinolaryngology and Related Specialities, 42(5): 258–265.CrossRefGoogle ScholarPubMed
Thomas, K. (1970). Laryngeal manifestations of Wegener's granuloma. Journal of Laryngology and Otology, 84: 101–105.CrossRefGoogle ScholarPubMed
van der Woude, F. J., Rasmussen, N., Lobatto, S., Wiik, A., Permin, H., van E's, L. A., van der Giessen, M., van der Hem, G. K. and The, T. H. (1985). Autoantibody against neutrophils and monocytes: a tool for diagnosis and marker of disease activity in Wegener's granulomatosis. Lancet, 1: 425–429.CrossRefGoogle ScholarPubMed
Wathen, C. W. and Harrison, D. J. (1987). Circulating antineutrophil cytoplasm antibodies in systemic vasculitis. Lancet, 1: 1037.CrossRefGoogle ScholarPubMed