Wegener's granulomatosis of the pediatric airway: a case demonstrating a conservative management approach.
Subglottic stenosis is found in 10% to 20% of patients with Wegener's granulomatosis, and at times, it may be the only indication of disease. This is particularly a problem in childhood-onset Wegener's granulomatosis, which is complicated 5 times more by subglottic and tracheal stenosis than in adult-onset disease. Because this is a rare disease that is often misdiagnosed as reactive airway disease in childhood, the discovery of subglottic stenosis is delayed until much of the chronic damage has already been done. This report discusses the diagnosis and management of a 12-year-old male with a severe, actively inflamed subglottis and trachea because of Wegener's granulomatosis. This study uses a retrospective case review. The study shows a successful symptomatic medical treatment of subglottic stenosis with resolution of tracheal inflammation and subglottic stenosis. Treatment of an actively inflamed trachea with subglottic stenosis because of Wegener's granulomatosis should focus on medical therapy, including steroids, before making attempts at surgical intervention.