A Case of Idiopathic Subglottic and Bilateral Bronchial Stenosis

Abstract

Subglottic stenosis is rarely idiopathic. In this case report, a 40-year-old female patient presented with subglottic stenosis with an unidentified etiology along with bilateral bronchial stenosis. Hoarseness arose in the last 4 years in this patient, who was undergoing treatment because of asthma for 13 years. Her physical examination revealed the presence of bilateral rhonci. Her tomography analysis revealed tracheal stenosis in a 2-cm segment at the C6-7 level. Her bronchoscopy analysis revealed subglottic stenosis. White plaques were observed in the entire tracheobronchial tree; biopsy was performed and lavage was taken. Samples were sent for pathological and microbiological examinations. Stenosis in the bronchial system was clear in the left main bronchus entry and at the right intermediate bronchus level. Dilatation was performed. Chronic active inflammation and squamous hyperplasia were observed in the pathology of the biopsies. Growth did not occur in tuberculosis and nonspecific cultures. Reflux was not present in the gastrointestinal system examination. All serological and rheumatologic examinations performed were normal. Idiopathic subglottic stenosis is exceedingly rare. Bronchial system stenosis accompanying idiopathic tracheal stenosis is even rarer, and its treatment is difficult.

Case report: Idiopathic subglottic stenosis in a girl; successful treatment with macrolides

“…Histologic evaluation of tracheal tissue biopsies usually shows unspecific acute and chronic active inflammation with epithelial ulceration ( 5 , 13 ) and subsequent squamous metaplasia ( 5 , 8 – 10 , 13 , 44 , 57 , 58 ), scattered eosinophilic infiltration ( 13 , 57 ), normal cartilage ( 23 , 57 ), and dilatation of mucus glands and ducts ( 5 , 23 ). Taking biopsies serves mainly to exclude other inflammatory causes of tracheal stenosis ( 4 ) as histopathological findings are not pathognomonic in iSGS.…”

“…These have been demonstrated in several pulmonary diseases, such as asthma, bronchiectasis, cystic fibrosis, primary ciliary dyskinesia, community acquired pneumonia and bronchiolitis obliterans ( 5 , 13 , 86 , 87 ). Macrolides are also used in skin diseases and inflammatory bowel diseases ( 5 , 8 – 10 , 13 , 44 , 57 , 58 , 88 ). Pro-inflammatory cytokines and mediators are decreased by macrolides, such as TNF-α, IFN-γ, IL-1ß, IL-4, IL-5, IL-6, IL-8.…”