• Justyna Fijolek, Elzbieta Wiatr, Dariusz Gawryluk, Magdalena Maria Martusewicz-Boros, Tadeusz Maria Orlowski, Dariusz Dziedzic, Malgorzata Polubiec-Kownacka, Karina Oniszh, Renata Langfort, and Kazimierz Roszkowski-Sliz.
• From the Third Department of Pneumonology, and Department of Thoracic Surgery, and Department of Radiology, and Department of Pathology, National Research Institute of Tuberculosis and Lung Diseases, Warsaw, Poland. jfijolek@op.pl.
• J Rheumatol. 2016 Nov 1; 43 (11): 2042-2048.

ObjectiveAn 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).MethodsReview and treatment with IDIT of 34 patients with SGS associated with GPA.ResultsSGS 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.ConclusionSGS 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.

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