Wegener's granulomatosis causing subglottic stenosis: Experiences at a tertiary care hospital of the Eastern India

Objectives: To study the clinical profile andmanagement of Wegener's granulomatosis [WG] with subglottic stenosis [SGS] at a tertiary teaching hospital in Eastern India

Methods: This prospective study incorporated a case series of six patients treated between 2007 and 2015 for WG with SGS. The demographic details of the patients, such as age, sex, clinical presentation, laryngeal endoscopy, imaging, laboratory tests, and medical and surgical options, are described

Results: Of the six patients, five had laryngeal symptoms, such as hoarseness or breathing difficulty, at the time of presentation. There were four female and two male patients ranging in age from 14 to 62 years. The diagnosis of all six patients was confirmed via histopathological examination. Of the six patients, one had isolated subglottic involvement, and four had a positive antineutrophilic cytoplasmic autoantibody [C-ANCA] test on presentation. All of the patients received immunosuppressant and steroid therapies at the time of diagnosis. Five patients required tracheostomy with subglottic dilatation with cold steel instruments followed by the local injection of steroids and mitomycin-C application. Four patients have shown clinical improvement

Conclusion: Although WG is a rare clinical condition, it is often confused with common ailments, which delays diagnosis, and it may involve the subglottis. The subglottis is a vital part of the laryngotracheal airway, and mild obstruction can be life threatening. The accurate and timely diagnosis of WG helps to prevent life-threatening complications, such as SGS

Isolated primary amyloidosis of the epiglottis presenting as a long-standing foreign body sensation in throat: a case report

Primary amyloidosis of the larynx is a rare benign disease of unknown aetiology. Isolated epiglottic involvement with amyloidosis is an extremely uncommon benign laryngeal pathology and can present with a foreign body sensation in the throat. This lesion should be kept in mind in cases with a long-standing foreign body sensation in the throat. Observation and endoscopic carbon dioxide laser excision are the main methods of treatment. Long-term follow-up is also required because of the slow progressive nature of this disease

Isolated case of mucosal histoid Hansen's disease of the nasal cavity in a post-global elimination era

Histoid Hansen's disease is a rare form of multibacillary leprosy with distinct clinical and histopathological features. This type of leprosy is a variant of lepromatous leprosy with a very high bacterial reserve. Of alarming concern is the discovery of an isolated mucosal histoid leprotic lesion inside the nasal cavity of a patient in the post-global leprosy elimination era. Our case had no history of leprosy or exposure to dapsone/multidrug therapy but had a heavy bacillary index. We are reporting this case to highlight the rarity of mucosal lesions due to histoid leprosy and involvement of the nasal cavity, as well as to create awareness and avoid misdiagnosis. This will help facilitate prompt treatment to minimize the complications and deformities of the patient and prevent its spread throughout the community