Laryngeal Manifestations of Inflammatory Bowel Disease

Loos, Elke; Lemkens, P; Poorten, Vincent Vander; Humblet, Evelien; Laureyns, Griet

doi:10.1016/j.jvoice.2017.09.021

Cited by 8 publications

(5 citation statements)

References 18 publications

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“…Patients who did not respond adequately to steroids were typically advanced to steroid-sparing systemic therapies commonly used in IBD, including nonbiologic medications (azathioprine, 6-mercaptopurine, mesalamine) and anti-tumor necrosis factor therapies (infliximab, adalimumab) with good success. 6 Surgical management can also be necessary to stabilize the airway, with one patient, in addition to the one described in this report, requiring tracheostomy 15 and one undergoing supraglottoplasty. 10 Although not previously reported for cases of laryngeal Crohn disease, CO2 laser resurfacing (''pepper pot'') techniques have been used to reduce airway redundancy and achieve decannulation in cases of laryngeal sarcoidosis 16 as well as idiopathic, nongranulomatous chronic supraglottitis.…”

Section: Discussionmentioning

confidence: 89%

“…4 Crohn disease is another cause of granulomatous inflammation that, while rare, can present with laryngeal manifestations. [5][6][7][8][9][10] Due to this patient's family history of inflammatory bowel disease and lack of other identifiable etiology, this was presumed to be the most likely diagnosis. Fecal calprotectin, a nonspecific marker of bowel inflammation, was notably positive and there were some gross signs of erosion identified on upper and lower GI endoscopy, but definitive histologic signs of inflammatory bowel disease were not found.…”

Section: Discussionmentioning

confidence: 99%

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Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

et al. 2020

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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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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

et al. 2020

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“…[5][6][7][8][9][10][11][12][13][14][15][16][17] Patients with laryngeal manifestations may present with a variety of symptoms including dysphagia, stridor, dyspnea, coughing, and hoarseness. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Extra-intestinal manifestations of Crohn's may sometimes appear before gastrointestinal symptoms, making diagnosis difficult. 7,8,17 Supraglottic structures are most commonly affected, as observed in our case report, however vocal cords may also show signs of involvement.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal Manifestations of Crohn’s Disease in a Toddler with Very Early Onset-IBD

Schonman

Sehgal

Javia

et al. 2021

Ann Otol Rhinol Laryngol

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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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“…Позакишкові прояви: ураження шкіри, васкуліт, суглобовий синдром, афтозний стоматит або параанальне ураження (анальний свербіж, мацерації, тріщини, парапроктити, свищі) -можуть бути першими симптомами у 6-23 % [9]. У сучасній літературі є описи поодиноких клінічних випадків дебюту ХК у вигляді ізольованих легеневих проявів [5], інфільтратів рогівки [6], у вигляді захворювань гортані [7]. Також є опис системних проявів дебюту ХК маніфестацією остеопорозу [8], автоімунного панкреатиту типу 2 [9], міалгії литкових м'язів [10], а також оральних лімфангіоектазій [11], абсцесу печінки [14].…”

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Bilateral gonarthrosis as the onset of Crohn’s disease in children: a clinical presentation

Ivanova,

Samoilenko,

Polesova

et al. 2023

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Crohn’s disease is an immune-mediated disease characterized by nonspecific granulomatous transmural inflammation with segmental damage to any part of the gastrointestinal tract with the formation of extraintestinal and systemic complications. The disease is complex, multifactorial, which lasts throughout life and affects the physical and psychological development of the individual. According to modern ideas, the occurrence of Crohn’s disease is influenced by external environmental factors against the background of genetic predisposition. According to the literature, in most cases, patients with Crohn’s disease complain of abdominal pain, diarrhea, unexplained anemia, fever, weight loss, or growth retardation. The classic triad of abdominal pain, diarrhea and weight loss occurs in only 25 % cases. Extraintestinal manifestations such as skin lesions, vasculitis, joint syndrome, aphthous stomatitis or para-anal lesions (anal itching, macerations, fissures, paraproctitis, fistulas) may be the first symptoms in 6–23 % of cases. The diagnosis of Crohn’s disease in children is made on the basis of anamnestic and clinical data, the results of using special research methods, including endoscopic, radiological, ultrasound, histological, spiral computer tomography, magnetic resonance imaging, as well as immunological and genetic markers. Achieving and maintaining remission can minimize psychological problems and improve patients’ quality of life. A clinical case of Crohn’s disease is presented, which was diagnosed in a 14-year-old child who was treated for juvenile idiopathic oligoarthritis since the age of two and had frequent bacterial and inflammatory diseases. The difficulties of diagnostic search are reflected, which are caused by various symptoms and early onset. Treatment and clinical monitoring were carried out in accordance with the international recommendations of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 2021. The authors emphasize the need for dynamic clinical monitoring of the patient’s condition, as well as a personalized approach to treatment.

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Laryngeal Manifestations of Inflammatory Bowel Disease

Cited by 8 publications

References 18 publications

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

Granulomatous Inflammation Causing Severe Supraglottic Edema and Airway Obstruction in a Pediatric Patient

Laryngeal Manifestations of Crohn’s Disease in a Toddler with Very Early Onset-IBD

Bilateral gonarthrosis as the onset of Crohn’s disease in children: a clinical presentation

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