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Bradshaw B, Jaffal H, Wysocki CA, Grover LA, Mitchell RB, Ulualp S, Shah GB, Chorney SR. Chronic Granulomatous Disease of the Upper Airway. EAR, NOSE & THROAT JOURNAL 2024; 103:289-292. [PMID: 34670444 DOI: 10.1177/01455613211054635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Brad Bradshaw
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hussein Jaffal
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Christian A Wysocki
- Departments of Internal Medicine and Pediatrics, Division of Allergy/Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lyndsey A Grover
- Division of Pediatric Anesthesiology, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pediatric Anesthesiology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Ron B Mitchell
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Seckin Ulualp
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Gopi B Shah
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Stephen R Chorney
- Department of Otolaryngology-Head & Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
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Schonman IA, Sehgal S, Javia LR, Bauman NM. Laryngeal Manifestations of Crohn's Disease in a Toddler with Very Early Onset-IBD. Ann Otol Rhinol Laryngol 2021; 130:1202-1206. [PMID: 33657845 DOI: 10.1177/0003489421998214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We report obstructing laryngeal manifestations of Crohn's disease in a toddler with very early onset-IBD (VEO-IBD) who required tracheotomy tube placement at 27 months of age for relief of recalcitrant airway obstruction unresponsive to maximal medical therapy. We review the literature for the frequency of extra-intestinal laryngeal manifestations of Crohn's disease in adults and children. METHODS Case report and literature review of laryngeal manifestations of Crohn's disease. RESULTS Laryngeal involvement of Crohn's disease is very rare with only 14 other cases reported. Most cases appear in adults, with the supraglottis most commonly affected. This case marks the youngest report and only the second report of a patient requiring a tracheotomy for supraglottic obstruction when intensive medical management, including use of steroids and biologics, failed to relieve obstructing laryngeal inflammation. Despite ongoing Crohn's disease, laryngeal manifestations improved permitting decannulation the following year. CONCLUSIONS Laryngeal manifestations of Crohn's disease are rare and usually affect adults. Most cases are managed with medical therapy, however surgical excision of obstructing lesions or tracheotomy placement is sometimes required for temporary relief of airway obstruction.
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Affiliation(s)
- Ian A Schonman
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sona Sehgal
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Departments of Gastroenterology, Hepatology and Nutrition (SS) and Otolaryngology Head and Neck Surgery (NMB), Children's National Hospital, Washington, DC, USA
| | - Luv R Javia
- Children's Hospital of Philadelphia, Department of Pediatric Otolaryngology and University of Pennsylvania, Philadelphia, PA, USA
| | - Nancy M Bauman
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Departments of Gastroenterology, Hepatology and Nutrition (SS) and Otolaryngology Head and Neck Surgery (NMB), Children's National Hospital, Washington, DC, USA
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Colevas SM, Gietman BT, Cook SM, Kille TL. Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient. EAR, NOSE & THROAT JOURNAL 2020; 101:NP375-NP378. [PMID: 33236923 DOI: 10.1177/0145561320973772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 12-year-old male with a family history of inflammatory bowel disease presented with sleep-disordered breathing and was found to have chronic, granulomatous swelling of the supraglottic larynx. His airway was managed with tracheostomy, regular interval laryngeal steroid injections, supraglottoplasty, and "pepper pot" CO2 laser resurfacing leading to eventual decannulation. Due to the non-necrotic nature of the granulomatous inflammation, as well as the patient's family history of inflammatory bowel disease, the leading diagnosis was Crohn disease, but isolated laryngeal sarcoidosis could not be ruled out. There are only 13 reported cases of laryngeal manifestations of Crohn disease in the literature, with only 2 cases occurring in pediatric patients. This case report adds to this body of literature and discusses strategies for managing granulomatous supraglottic edema when definitive diagnosis is not fully clear.
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Affiliation(s)
- Sophia M Colevas
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 5232University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bradley T Gietman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 5232University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Shelly M Cook
- Department of Pathology and Laboratory Medicine, 5232University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tony L Kille
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 5232University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Cernomaz AT, Bordeianu G, Terinte C, Gavrilescu CM. Nonasthmatic eosinophilic bronchitis in an ulcerative colitis patient – a putative adverse reaction to mesalazine: A case report and review of literature. World J Clin Cases 2020; 8:4162-4168. [PMID: 33024774 PMCID: PMC7520771 DOI: 10.12998/wjcc.v8.i18.4162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/06/2020] [Accepted: 08/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lung and airway involvement in inflammatory bowel disease are increasingly frequently reported either as an extraintestinal manifestation or as an adverse effect of therapy.
CASE SUMMARY We report a case of a patient with ulcerative colitis controlled under mesalazine treatment who presented with chronic cough and hemoptysis. Chest computed tomography and bronchoscopy findings supported tracheal involvement in ulcerative colitis; pathology examination demonstrated an unusual eosinophil-rich inflammatory pattern, and together with clinical data, a nonasthmatic eosinophilic bronchitis diagnosis was formulated. Full recovery was observed within days of mesalazine discontinuation.
CONCLUSION Mesalazine-induced eosinophilic respiratory disorders have been previously reported, generally involving the lung parenchyma. To the best of our knowledge, this is the first report of mesalamine-induced eosinophilic involvement in the upper airway.
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Affiliation(s)
- Andrei Tudor Cernomaz
- Department of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Gabriela Bordeianu
- Department of Biochemistry, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Cristina Terinte
- Department of Pathology, Regional Oncology Institute, Iasi 700483, Romania
| | - Cristina Maria Gavrilescu
- Department of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi 700115, Romania
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Yver C, Jhala D, Muir A, Basu D. Managing head and neck malignancy arising in a field of Crohn disease inflammation: Report of a case. EAR, NOSE & THROAT JOURNAL 2018; 96:E1-E4. [PMID: 29121377 DOI: 10.1177/0145561317096010-1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some of the clinical characteristics of Crohn disease of the head and neck overlap those of squamous cell carcinoma of the head and neck. We describe the diagnostic and therapeutic complexities we encountered in an unusual case of piriform sinus cancer that had arisen in a field of pharyngeal Crohn disease. Based on our initial failure to recognize the predominant inflammatory component of the lesion, we discuss the special considerations that must be made for the detection, staging, and management of head and neck cancer in Crohn disease patients. We further describe the multiple potential interactions among smoking, inflammation, and immunosuppression therapy in the colocalized pathogenesis of the two disease states.
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Affiliation(s)
- Christina Yver
- Department of Otolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce St., 5 Ravdin/Silverstein, Philadelphia, PA 19104, USA.
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Loos E, Lemkens P, Poorten VV, Humblet E, Laureyns G. Laryngeal Manifestations of Inflammatory Bowel Disease. J Voice 2018; 33:1-6. [PMID: 29605161 DOI: 10.1016/j.jvoice.2017.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/24/2017] [Accepted: 09/27/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Laryngeal involvement in inflammatory bowel disease is rare. Only 12 cases of laryngeal involvement in Crohn disease have been reported until now. Moreover, only one case of laryngeal manifestations in ulcerative colitis has been reported so far. MATERIALS AND METHODS In this article, we present a patient with ulcerative colitis, who consulted our ear, nose, and throat (ENT) clinic with laryngeal complaints. Furthermore, a review of current literature was performed. RESULTS A concise overview of this rare extraintestinal manifestation and other ENT manifestations of inflammatory bowel diseases is provided. CONCLUSIONS Laryngeal manifestations in inflammatory bowel disease are very rare, but these manifestations should be known by the otorhinolaryngologist.
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Affiliation(s)
- Elke Loos
- Department of Otorhinolaryngology-Head and Neck Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium; Department of Otorhinolaryngology-Head and Neck Surgery, KULeuven, Leuven, Belgium
| | - Peter Lemkens
- Department of Otorhinolaryngology-Head and Neck Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | - Evelien Humblet
- Department of Gastroenterology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Griet Laureyns
- Department of Otorhinolaryngology-Head and Neck Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
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