PT  - JOURNAL ARTICLE
AU  - Justyna Fijolek
AU  - Elzbieta Wiatr
AU  - Dariusz Gawryluk
AU  - Magdalena Maria Martusewicz-Boros
AU  - Tadeusz Maria Orlowski
AU  - Dariusz Dziedzic
AU  - Malgorzata Polubiec-Kownacka
AU  - Karina Oniszh
AU  - Renata Langfort
AU  - Kazimierz Roszkowski-Sliz
TI  - Intratracheal Dilation-injection Technique in the Treatment of Granulomatosis with Polyangiitis Patients with Subglottic Stenosis
AID  - 10.3899/jrheum.151355
DP  - 2016 Nov 01
TA  - The Journal of Rheumatology
PG  - 2042--2048
VI  - 43
IP  - 11
4099  - http://www.jrheum.org/content/43/11/2042.short
4100  - http://www.jrheum.org/content/43/11/2042.full
SO  - J Rheumatol2016 Nov 01; 43
AB  - Objective. An analysis of subglottic stenosis (SGS) occurrence frequency in patients with granulomatosis with polyangiitis (GPA) based on the time of appearance of clinical symptoms, and an assessment of treatment effectiveness, in particular with the intratracheal dilation-injection technique (IDIT).Methods. Review and treatment with IDIT of 34 patients with SGS associated with GPA.Results. SGS developed in 34 of 250 patients with GPA (13.6%) and was not reflective of disease activity in the organs in 15 of 34 patients (44%): 11 cases after and 4 cases during immunosuppressive therapy (IST) when patients did not have organ symptoms. All patients underwent IDIT and in total, the treatment resulted in immediate improvement. In addition, in 21 cases, IST was applied because of other organ involvement or of the lack of longterm efficacy of IDIT. The median time of response was 37 months and the median interval between sessions was 5 months. None of the patients required tracheostomy after beginning IDIT in our hospital.Conclusion. SGS often occurs independently of other features of active GPA. IDIT is a safe and effective technique in the treatment of GPA-related SGS. It should be performed in all patients with GPA who develop significant SGS and in those with multiorgan disease concomitantly with IST. In patients with isolated SGS, IDIT also makes IST and tracheostomy unnecessary.