Document Detail

Severe upper airway obstruction from cricoarytenoiditis as the sole presenting manifestation of a systemic lupus erythematosus flare.
MedLine Citation:
PMID:  11888989     Owner:  NLM     Status:  MEDLINE    
Upper airway obstruction due to laryngeal involvement is a known complication of systemic lupus erythematosus (SLE). Laryngeal involvement typically accompanies inflammatory activity involving other sites and varies from mild mucosal inflammation to bilateral vocal cord immobility. Cricoarytenoid arthropathy is a rare cause of severe airway obstruction in patients with SLE and almost always occurs in the presence of other associated symptoms. Furthermore, in contrast to patients with rheumatoid arthritis, in whom chronic involvement of cricoarytenoid joints occurs more commonly and often requires surgical intervention, patients with SLE typically present with acute arthritis of cricoarytenoid joints and respond to corticosteroid therapy alone. We describe a patient with known SLE who presented with severe acute upper airway obstruction as the sole manifestation of active SLE after several years of quiescence. The laryngeal involvement progressed from mucosal inflammation to acute cricoarytenoiditis, despite the administration of high-dose corticosteroid therapy, necessitating emergent intubation and tracheostomy. This case illustrates the importance of considering SLE in the differential diagnosis of patients presenting with acute upper airway obstruction.
Anita Karim; Shahid Ahmed; Rina Siddiqui; Galina S Marder; Joseph Mattana
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Chest     Volume:  121     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-12     Completed Date:  2002-04-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  990-3     Citation Subset:  AIM; IM    
Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
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MeSH Terms
Airway Obstruction
Arytenoid Cartilage*
Cartilage Diseases / complications,  diagnosis*
Cricoid Cartilage*
Laryngeal Diseases / complications,  diagnosis*
Lupus Erythematosus, Systemic / complications,  diagnosis*
Middle Aged

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