Диагностические критерии поражения гортани при манифестации ревматоидного артрита

Abstract

Introduction. Rheumatoid arthritis is a systemic autoimmune inflammation of connective tissue involving the cartilage of the larynx. In this case, pathology of the larynx may be the only manifestation of this disease. The discomfort, foreign body sensation, and pain in the larynx noted by patients in the early stages of the disease are rarely associated by doctors with the manifestation of rheumatoid arthritis. In later stages, symptoms may be masked as comorbid pathology of the heart or upper respiratory tract. An analysis of the available literature revealed insufficient knowledge of issues related to the early diagnosis of inflammation of the larynx in autoimmune diseases, in particular, rheumatoid arthritis. Objective. To conduct a literature review to identify early symptoms of laryngeal damage in patients with the manifestation of rheumatoid arthritis. Materials and methods. Over the past 10 years, a literature review has been conducted in public databases using the following queries: laryngeal injury in autoimmune rheumatic diseases, dysphonia, voice impairment in rheumatoid arthritis, rheumatoid arthritis, and laryngeal joint injury. Data from literature sources, the authors of which made a significant contribution to the development of otorhinolaryngology and rheumatology, were included. Results. Summary data from the literature review are presented on the frequency of complaints made by patients, verification of characteristic symptoms, and their severity depending on the level of damage to the larynx. An early symptom of the manifestation of rheumatoid arthritis is dysphonia, which was observed with inflammation of the cricoarytenoid joints, arytenoid cartilage, and vocal fold nodules. A checklist of early symptoms of laryngeal injury has been compiled for routing patients with rheumatoid arthritis. Conclusion. Laryngeal involvement in rheumatoid arthritis is a fairly common symptom. Dysphonia as an early symptom is observed with polymorphism of inflammatory changes and manifests itself from single nodules to total fixation of the joints of the laryngeal cartilage. In diagnosing the manifestations of rheumatoid arthritis, an interdisciplinary approach of specialists is required.