Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

IgG4-Related Laryngeal Disease as a Possible Cause of Idiopathic Subglottic Stenosis: A Case Report

Document Type : Case Report

Authors
Ádám Bach 1
Andrea Ambrus 1
Béla Iványi 2
Zoltán Tóbiás 1
Gholam Hossein Alim Marvasti 1
László Rovó 1
1 Department of Otorhinolaryngology & Head- Neck Surgery, University of Szeged; Tisza Lajos krt. 111., 6725, Szeged, Hungary.
2 Department of Pathology, University of Szeged, Állomás u. 2, 6725, Szeged, Hungary.
10.22038/ijorl.2020.47106.2547
Abstract
Introduction:
Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibro-inflammatory disorder.  Laryngotracheal manifestation is very rare; therefore, it is usually associated with complex diagnostic and therapeutic problems.
 
Case Report:
Herein, we report the case of a 35-year-old woman with idiopathic subglottic stenosis (ISGS) treated with one-step laryngotracheal reconstruction surgery. Postoperatively, the lesion was found to be a part of the IgG4-RD spectrum. Objective and subjective phoniatric tests, spirometry, and Quality of Life Questionnaire were used for the evaluation of postoperative functional results. Slide laryngotracheoplasty as a one-step surgery without stenting and tracheostomy ensured a sufficiently wide subglottic space with no adverse effect on voice quality. During a follow-up period of 22 months, endoscopy and computed tomography scan revealed no significant restenosis. The patient was able to return to premorbid activities of daily living without any further medical treatment.
Conclusion:
The laryngeal involvement of IgG4-RD is uncommon; however, it is a manifestation that should be included in the differential diagnosis of subglottic stenoses (SGS). Furthermore, subglottic IgG4-RD might be a potential etiological factor of ISGS and acquired airway stenosis after short-term intubation. Slide laryngotracheoplasty might be a favorable solution without stenting and tracheostomy even in special cases of SGS.
Keywords
Fibro-inflammatory disorder
Idiopathic subglottic stenosis
IgG4
Laryngotracheoplasty
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Iranian Journal of Otorhinolaryngology
Volume 33, Issue 2
March and April 2021
Pages 119-125