Tracheobronchial involvement in Wegener's granulomatosis

Timothy E. Daum, Ulrich Specks, Thomas V. Colby, Eric S. Edell, Mark W. Brutinel, Udaya B.S. Prakash, Richard A. DeRemee

Research output: Contribution to journalArticlepeer-review

172 Scopus citations

Abstract

This study was designed to characterize the clinical spectrum and course of tracheobronchial involvement in Wegener's granulomatosis (WG). Of the 51 patients with biopsy-proven WG who underwent bronchoscopy at least once at our institution between January 1982 and November 1993, 30 (59%) had endobronchial abnormalities due to WG. Initial findings included subglottic stenosis in five (17%), ulcerating tracheobronchitis with or without inflammatory pseudotumors in 18 (60%), tracheal or bronchial stenosis without inflammation in four (13%), and hemorrhage without identifiable source in two (4%) patients. Nine patients with ulcerating tracheobronchitis on initial study had subsequent bronchoscopies for continued symptoms, which in seven cases documented the progression from ulcerating tracheobronchitis to stenosis without inflammation. Bronchoscopic interventions included dilation by rigid bronchoscope in three, YAG-laser treatment in one, and placement of silastic airway stents in three patients. Only the stents provided persistent airway patency. Endobronchial biopsies were performed on 21 occasions in 17 patients. Half of the specimens were helpful in establishing the diagnosis and in all but three in assessing disease activity. While antineutrophil cytoplasmic antibody liters reflect overall disease activity, no correlation with endobronchial inflammatory activity was apparent.

Original languageEnglish (US)
Pages (from-to)522-526
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Volume151
Issue number2 I
DOIs
StatePublished - Feb 1995

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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