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Three cases of rheumatoid arthritis with laryngeal stridor

Identifieur interne : 001E86 ( Istex/Corpus ); précédent : 001E85; suivant : 001E87

Three cases of rheumatoid arthritis with laryngeal stridor

Auteurs : James E. Peters ; Christopher J. Burke ; Vanessa H. Morris

Source :

RBID : ISTEX:2DBE00D983BD59A3532C243298E1D0572FB040E3

English descriptors

Abstract

Abstract: The purpose of this is case-based review is to report a series of patients with rheumatoid arthritis who developed stridor and highlight this potentially life-threatening manifestation of the disease. We report three cases from the Rheumatology Department of University College Hospital, London and review the literature on the prevalence, clinical presentation, histopathological features and treatment of laryngeal involvement in rheumatoid arthritis. In two patients, emergency tracheostomy was necessary to maintain a patent airway. One patient improved with systemic corticosteroids without the need for surgical intervention. All patients were seropositive with anti-CCP antibodies and had long-standing erosive disease. Stridor in patients with rheumatoid arthritis is typically due to arthritis of the cricoarytenoid joints leading to fixation of the vocal cords in a midline position. Cricoarytenoid joint arthritis may be acute, chronic, or acute-on-chronic. Emergency tracheostomy may be life-saving in cases of acute stridor. Cricoarytenoid inflammation and airway compromise may respond to local or systemic corticosteroid therapy. Other causes of vocal cord paresis in rheumatoid arthritis include ischaemic neuropathy of the recurrent laryngeal and vagus nerves due to vasculitis or cervicomedullary compression due to rheumatoid involvement of the cervical spine.

Url:
DOI: 10.1007/s10067-010-1657-2

Links to Exploration step

ISTEX:2DBE00D983BD59A3532C243298E1D0572FB040E3

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<title>Three cases of rheumatoid arthritis with laryngeal stridor</title>
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<title>Three cases of rheumatoid arthritis with laryngeal stridor</title>
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<namePart type="given">James</namePart>
<namePart type="given">E.</namePart>
<namePart type="family">Peters</namePart>
<affiliation>Department of Rheumatology, University College Hospital, 235 Euston Road, NW1 2BU, London, UK</affiliation>
<affiliation>E-mail: jimmypeters1980@yahoo.co.uk</affiliation>
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<name type="personal">
<namePart type="given">Christopher</namePart>
<namePart type="given">J.</namePart>
<namePart type="family">Burke</namePart>
<affiliation>Department of Radiology, Guy’s Hospital, Great Maze Pond, SE1 9RT, London, UK</affiliation>
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<name type="personal">
<namePart type="given">Vanessa</namePart>
<namePart type="given">H.</namePart>
<namePart type="family">Morris</namePart>
<affiliation>Department of Rheumatology, University College Hospital, 235 Euston Road, NW1 2BU, London, UK</affiliation>
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<dateCreated encoding="w3cdtf">2010-10-26</dateCreated>
<dateIssued encoding="w3cdtf">2011-05-01</dateIssued>
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<abstract lang="en">Abstract: The purpose of this is case-based review is to report a series of patients with rheumatoid arthritis who developed stridor and highlight this potentially life-threatening manifestation of the disease. We report three cases from the Rheumatology Department of University College Hospital, London and review the literature on the prevalence, clinical presentation, histopathological features and treatment of laryngeal involvement in rheumatoid arthritis. In two patients, emergency tracheostomy was necessary to maintain a patent airway. One patient improved with systemic corticosteroids without the need for surgical intervention. All patients were seropositive with anti-CCP antibodies and had long-standing erosive disease. Stridor in patients with rheumatoid arthritis is typically due to arthritis of the cricoarytenoid joints leading to fixation of the vocal cords in a midline position. Cricoarytenoid joint arthritis may be acute, chronic, or acute-on-chronic. Emergency tracheostomy may be life-saving in cases of acute stridor. Cricoarytenoid inflammation and airway compromise may respond to local or systemic corticosteroid therapy. Other causes of vocal cord paresis in rheumatoid arthritis include ischaemic neuropathy of the recurrent laryngeal and vagus nerves due to vasculitis or cervicomedullary compression due to rheumatoid involvement of the cervical spine.</abstract>
<note>Case Based Review</note>
<subject lang="en">
<genre>Keywords</genre>
<topic>Cricoarytenoid joint</topic>
<topic>Rheumatoid arthritis</topic>
<topic>Stridor</topic>
<topic>Tracheostomy</topic>
<topic>Vocal cord paresis</topic>
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<title>Clinical Rheumatology</title>
<subTitle>Journal of the International League of Associations for Rheumatology</subTitle>
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<title>Clin Rheumatol</title>
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<dateIssued encoding="w3cdtf">2011-04-27</dateIssued>
<copyrightDate encoding="w3cdtf">2011</copyrightDate>
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<subject>
<genre>Medicine & Public Health</genre>
<topic>Rheumatology</topic>
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<identifier type="ISSN">0770-3198</identifier>
<identifier type="eISSN">1434-9949</identifier>
<identifier type="JournalID">10067</identifier>
<identifier type="IssueArticleCount">23</identifier>
<identifier type="VolumeIssueCount">12</identifier>
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<date>2011</date>
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<number>30</number>
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<number>5</number>
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<start>723</start>
<end>727</end>
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<identifier type="DOI">10.1007/s10067-010-1657-2</identifier>
<identifier type="ArticleID">1657</identifier>
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<accessCondition type="use and reproduction" contentType="copyright">Clinical Rheumatology, 2011</accessCondition>
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