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Journal Information
Vol. 67. Issue 3.
Pages e24 (May - June 2016)
Vol. 67. Issue 3.
Pages e24 (May - June 2016)
Images in Otorhinolaryngology
DOI: 10.1016/j.otoeng.2016.04.009
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Wegener Granulomatosis With Supraglottic Involvement
Granulomatosis de Wegener con afectación supraglótica
Carlos Miguel Chiesa Estomba
Corresponding author

Corresponding author.
, Alejandra Osorio Velázquez, Adela Pérez-Carro Ríos
Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
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A female, Caucasian patient aged 29 with no medical history of interest. After her first pregnancy she was admitted to the internal medicine department due to multiple diarrhoea episodes with stool cultures (–), presenting with multiple ulcers, the punch biopsy of the colon testing positive for vasculitis; necrotic papular lesions on the skin with biopsy showing perivascular granulomatous dermatitis; pulmonary lesions in ground glass areas and right hilar lymph nodes accompanied by pulmonary nodes, the transbronchial biopsy of which tested positive for vasculitis.

The patient was referred to the ENT department due to intense odynophagia and when questioned denied any symptoms of stridor or difficulty breathing. Examination revealed an ulcerated lesion of approximately 1.2cm, which predominantly involved the left side of the laryngeal part of the epiglottis and left aryepilottic fold (Fig. 1) with no subglottic involvement.


ANCA markers and anti-proteinase 3 tested positive. Tubercular involvement was ruled out, as was haematological disease, sarcoidosis, cancer or other diagnoses. Correlation of clinical and preclinical findings resulted in the diagnosis of Wegener granulomatosis. The patient received treatment with prednisone+rituximab, and clinical evolution was favourable.

Wegener granulomatosis is a rare, multisystemic disease which frequently involves otorhinolaryngology symptoms. It is characterised by the formation of necrotising granulomas in the respiratory tract, vasculitis and glomerulonephritis. Mean age of presentation is between 20 and 40, with both genders being equally affected, predominantly Caucasians. The most common otorhinolaryngology symptoms are nasal (80%), hearing loss (24%), dysphonia (15%) and stridor (15%), with the latter 2 symptoms associated with the presence of subglottic stenosis. Supraglottic involvement is, however, infrequent.

Please cite this article as: Chiesa Estomba CM, Osorio Velázquez A, Pérez-Carro Ríos A. Granulomatosis de Wegener con afectación supraglótica. Acta Otorrinolaringol Esp. 2016;67:e24.

Copyright © 2015. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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