The Journal of Laryngology & Otology

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Aspiration and development of subglottic stenosis in patients with Wegener’s granulomatosis

A C Churcha1 c1, K Goldsmitha2 and P Sivasothya2

a1 Scottish Pulmonary Vascular Unit, Golden Jubilee Hospital, Glasgow, Scotland, UK

a2 Department of Respiratory Medicine, Papworth Hospital, Cambridge, England, UK

Abstract

Objective: In patients with Wegener’s granulomatosis, subglottic stenosis can develop due to active disease; however, some patients develop subglottic stenosis with no clear evidence of airway inflammation. In some cases of idiopathic subglottic stenosis, an association with gastroesophageal reflux disease has been found. Our study assessed the potential role of gastroesophageal reflux as an aetiological factor in the development of subglottic stenosis in patients with Wegener’s granulomatosis.

Design: We assessed evidence of active reflux disease, using 24-hour pH monitoring and assessment of bile salts in bronchoalveolar lavage fluid.

Subjects: Ten Wegener’s granulomatosis patients with subglottic stenosis underwent 24-hour pH monitoring and bronchoscopy and lavage of the right middle lobe. A similar number of control patients were included.

Results: There was no statistically significant difference in the occurrence of bronchoalveolar bile salts in patients with subglottic stenosis (n = 2) versus control patients (zero) (p = 0.457). There was good correlation between the detection of reflux by 24-hour pH monitoring and the detection of bronchoalveolar bile salts (κ = 0.769).

Conclusion: In this small study of patients with Wegener’s granulomatosis, there was no evidence of an association between the development of subglottic stenosis and gastroesophageal reflux.

(Accepted July 24 2009)

(Online publication November 25 2009)

Correspondence:

c1 Address for correspondence: Dr A C Church, Golden Jubilee Hospital, Beardmore Street, Clydebank, Glasgow G81 4HX, Scotland, UK. Fax: +44 (0)141 2329423 E-mail: colinchurch@doctors.org.uk

Footnotes

Presented at the American Thoracic Society meeting, 15 May 2007, San Francisco, USA.

Dr A C Church takes responsibility for the integrity of the content of the paper.

Competing interests: None declared