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Eosinophilic granulomatosis with polyangiitis and laryngeal involvement: review of the literature and a cross-sectional prospective experience

Published online by Cambridge University Press:  11 June 2018

V Seccia ,
L Cristofani-Mencacci ,
I Dallan ,
S Fortunato ,
M L Bartoli ,
S Sellari-Franceschini ,
M Latorre ,
P L Paggiaro  and
C Baldini
V Seccia
Affiliation:
First Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
L Cristofani-Mencacci*
Affiliation:
First Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
I Dallan
Affiliation:
First Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
S Fortunato
Affiliation:
First Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
M L Bartoli
Affiliation:
Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
S Sellari-Franceschini
Affiliation:
First Otorhinolaryngology Unit, Department of Neuroscience, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
M Latorre
Affiliation:
Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
P L Paggiaro
Affiliation:
Respiratory Pathophysiology Unit, Cardio-Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
C Baldini
Affiliation:
Rheumatology Unit, University of Pisa, Italy
*
Address for correspondence: Dr Lodovica Cristofani-Mencacci, First Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa n.2, 56124, Pisa, Italy Fax: +39 050 997542 E-mail: [email protected]
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Abstract

Background

Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis show variable otorhinolaryngological involvement. Up to 14 per cent of granulomatosis with polyangiitis patients have subglottis involvement; little is known about the laryngeal involvement in eosinophilic granulomatosis with polyangiitis.

Method

A literature review was conducted, together with a prospective cross-sectional analysis of 43 eosinophilic granulomatosis with polyangiitis patients. All patients underwent fibre-optic laryngoscopy with narrow-band imaging, and completed health-related questionnaires.

Results

The literature review showed only two cases of laryngeal involvement in eosinophilic granulomatosis with polyangiitis; in our cohort, no cases of subglottis stenosis were found, but local signs of laryngeal inflammation were present in 72 per cent of cases. Of the patients, 16.2 per cent had a pathological Reflux Finding Score (of 7 or higher).

Conclusion

Laryngeal inflammation in eosinophilic granulomatosis with polyangiitis is frequent. It is possibly due more to local factors than to eosinophilic granulomatosis with polyangiitis itself. However, ENT evaluation is needed to rule out possible subglottis inflammation. These findings are in line with current literature and worthy of confirmation in larger cohorts.

Keywords

LaryngitisLaryngostenosisLaryngopharyngeal RefluxLaryngoscopyChurg-Strauss Syndrome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 619 - 623
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr L Cristofani-Mencacci takes responsibility for the integrity of the content of the paper

References

1Groh, M, Pagnoux, C, Baldini, C, Bel, E, Bottero, P, Cottin, V et al. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) Consensus Task Force recommendations for evaluation and management. Eur J Intern Med 2015;26:545–53Google Scholar
2Masi, AT, Hunder, GG, Lie, JT, Michel, BA, Bloch, DA, Arend, WP et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990;33:1094–100Google Scholar
3Bacciu, A, Bacciu, S, Mercante, G, Ingegnoli, F, Grasselli, C, Vaglio, A et al. Ear, nose and throat manifestations of Churg-Strauss syndrome. Acta Otolaryngol 2006;126:503–9Google Scholar
4Gouveris, H, Karaiskaki, N, Koutsimpelas, D, Chongolwatana, C, Mann, W. Treatment for adult idiopathic and Wegener-associated subglottic stenosis. Eur Arch Otorhinolaryngol 2013;270:989–93Google Scholar
5Belloso, A, Estrach, C, Keith, AO. Supraglottic stenosis in localized Wegener granulomatosis. Ear Nose Throat J 2008;87:E11–14Google Scholar
6Del Pero, MM, Jayne, D, Chaudhry, A, Sivasothy, P, Jani, P. Long-term outcome of airway stenosis in granulomatosis with polyangiitis (Wegener granulomatosis): an observational study. JAMA Otolaryngol Head Neck Surg 2014;140:1038–44Google Scholar
7Wang, WH, Tsai, KY. Narrow-band imaging of laryngeal images and endoscopically proven reflux esophagitis. Otolaryngol Head Neck Surg 2015;152:874–80Google Scholar
8Luqmani, RA, Bacon, PA, Moots, RJ, Janssen, BA, Pall, A, Emery, P et al. Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis. QJM 1994;87:671–8Google Scholar
9Exley, AR, Bacon, PA, Luqmani, RA, Kitas, GD, Gordon, C, Savage, CO et al. Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides. Arthritis Rheum 1997;40:371–80Google Scholar
10Belafsky, PC, Postma, GN, Koufman, JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope 2001;111:1313–17Google Scholar
11Rasmussen, N. Management of the ear, nose, and throat manifestations of Wegener granulomatosis: an otorhinolaryngologist's perspective. Curr Opin Rheumatol 2001;13:3–11Google Scholar
12Guerrero, M, Gall, E, Tilahun, E, Garon, J. Wegener's granulomatosis presenting as subglottic stenosis. J Clin Rheumatol 2001;7:91–6Google Scholar
13Comarmond, C, Pagnoux, C, Khellaf, M, Cordier, JF, Hamidou, M, Viallard, JF et al. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort. Arthritis Rheum 2013;65:270–81Google Scholar
14Guillevin, L, Pagnoux, C, Seror, R, Mahr, A, Mouthon, L, Le Toumelin, P. French Vasculitis Study Group (FVSG). The Five-Factor Score revisited: assessment of prognoses of systemic necrotizing vasculitides based on the French Vasculitis Study Group (FVSG) cohort. Medicine (Baltimore) 2011;90:19–27Google Scholar
15Mazzantini, M, Fattori, B, Matteucci, F, Gaeta, P, Ursino, F. Neuro-laryngeal involvement in Churg-Strauss syndrome. Eur Arch Otorhinolaryngol 1998;255:302–6Google Scholar
16Al-Ammar, AY, Yasin, SS, Al-Muhsen, SZ, Al-Saadi, MM, Al-Sohaibani, MO. A laryngeal presentation of Churg-Strauss syndrome in childhood. Ann Saudi Med 2009;29:142–5Google Scholar
17Cojocaru, M, Cojocaru, IM, Silosi, I, Vrabie, CD. Gastrointestinal manifestations in systemic autoimmune diseases. Maedica (Buchar) 2011;6:45–51Google Scholar
18Pagnoux, C, Mahr, A, Cohen, P, Guillevin, L. Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis. Medicine (Baltimore) 2005;84:115–28Google Scholar