Cricoarytenoid arthritis

1978 ◽  
Vol 92 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Geoffrey A. Smith ◽  
Paul H. Ward ◽  
George Berci

AbstractTwo cases with laryngeal manifestations of systemic lupus erythematosus presented demonstrate the value of serial indirect laryngeal photography and results of treatment for the mucosal and serosal effects of the disease.Systemic lupus erythematosus is an autoimmune collagen vascular disease which produces widespread damage to connective tissue, blood vessels, serosal surfaces and mucous membranes (Rodman et ah, 1973). It is no surprise that with such a widespread disorder the upper airways too may show involvement.Estimates of the number of patients with laryngeal involvement have ranged from one percent by Dubois (1966) to one-third of patients by other authors (Babich and Tranaov, 1970; Minchina et al., 1971).Systemic lupus erythematosus may cause laryngeal symptoms referrable to an active mucosal, submucosal or serosal process. With acute flares of the disease, mucosal ulceration, edema, and submucosal hematomas may result in hoarseness and throat pain (Scarpelli et al., 1959). One case of epiglottitis caused by increased mucosal swelling has been reported (Toomey et al., 1974). As the disease progresses, late effects of mucosal disease including corditis, mucosal thickening, laryngeal scarring with stenosis and laryngitis with dry, thickened vocal cords may appear (Babich and Tramaov, 1970; Smith and Ferguson, 1976). With serosal involvement, the patient may demonstrate perichrondritis, cricoarytenoid arthritis or actual vocal cord paralysis (Dubois, 1966; Montgomery and Lofgren, 1963).Histopathologic study of involved mucosa along with cultures of the tissue is not diagnostic of systemic lupus erythematosus but can help to rule out other disorders similar in appearance such as tuberculosis and rhinoscleroma. Klebsiella rhinoscleromata infections particularly can cause a similar early inflammatory mucosal and late scarred picture.Microscopic sections of mucosa from a patient who died of laryngeal edema secondary to systemic lupus erythematosus appeared similar to mucosa from a patient with subglottic stenosis (Smith and Ferguson, 1976) with an infiltration of histiocytes, lymphocytes, plasma and mast cells.The following two cases demonstrate the differences in the course of serosal and mucosal airways disease.


1988 ◽  
Vol 7 (2) ◽  
pp. 288-290 ◽  
Author(s):  
J. B. M. Ten Holter ◽  
F. L. Van Buchem ◽  
H. J. Van Beusekom

1973 ◽  
Vol 83 (3) ◽  
pp. 372-375 ◽  
Author(s):  
D Bryer ◽  
F J Rounthwaite

The Lancet ◽  
1998 ◽  
Vol 351 (9109) ◽  
pp. 1099-1100 ◽  
Author(s):  
AR Absalom ◽  
R Watts ◽  
A Kong

2009 ◽  
Vol 16 (2) ◽  
pp. 161
Author(s):  
Ju Kyeon Yim ◽  
Sung Dong Kwak ◽  
Jae Young Park ◽  
Jae Hong Cheon ◽  
Sung Yeol Choi ◽  
...  

1959 ◽  
Vol 260 (2) ◽  
pp. 66-69 ◽  
Author(s):  
William W. Montgomery

1974 ◽  
Vol 83 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Frank E. Lucente

Connective tissue disorders may present with various otolaryngologic symptoms. The manifestations may represent vasculopathy, arthopathy, neuropathy or a combination of pathological processes. Rheumatoid arthritis may involve the middle ear, temporomandibular joints and larynx with mild symptoms or may be life-threatening in instances of cricoarytenoid arthritis. Dermatomyositis with its cutaneous and muscular symptoms prevalent in the head and neck is frequently associated with malignancy in patients over 40. Scleroderma not only affects the gastrointestinal tract but can also produce significant limitations of respiratory function. Systemic lupus erythematosus, polyarteritis modosa, Wegener's granulomatosis and giant cell arteritis produce numerous vascular changes in structures of otolaryngologic significance. In this puzzling group of disorders, protean symptoms may precede the development of a fulminant, widespread and fatal disease.


BMJ ◽  
1973 ◽  
Vol 3 (5872) ◽  
pp. 145-146 ◽  
Author(s):  
J A Wojtulewski ◽  
R D Sturrock ◽  
A C Branfoot ◽  
F D Hart

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