Laryngeal assessment in patients with rheumatic disease

Abstract

Objectives: Autoimmune diseases can cause laryngeal involvement with a highly variable course ranging from asymptomatic to severe states. Just few cases have been described since 1959, when the first laryngeal manifestation of systemic lupus erithematosus (SLE) was published. The aim of this article is to identify and to describe laryngeal manifestations of autoimmune diseases. Methods: Transversal study with patients presenting SLE, scleroderma, or undifferentiated connective tissue syndrom (UCTS) at Sao Paulo HospitalUniversidade Federal de Sao Paulo/Escola Paulista de MedicinaSao Paulo, Brazil. These patients underwent otorhinolaryngologic evalution with laryngeal videostroboscopic image. Results: Twenty-six patients underwent laryngeal videostroboscopic evaluation. One patient could not support the exam. Eleven of 12 (91.6%) patients with SLE presented edema of interarytenoid tissue. Bamboo nodes, that are yellow transverse submucosal vocal fold deposit lesions, were seen in 03 (25%) patients with SLE. One (8.33%) patient had unilateral sulcus vocalis. All 11 patients with scleroderma presented reflux laryngopharyngitis. Two (18.1%) patients presented dilatation of vocal fold blood vessels and another 2 patients presented vocal fold nodule. Among 3 patients with UCTS, in 2 (66.7%) were seen bamboo nodes and reflux laryngopharyngitis. Conclusion: Laryngeal manifestations due to autoimmune diseases were seen in 07 (26.9%) of 26 patients. Bamboo nodes were seen in 5 (19.2%) patients. Almost all patients presented reflux laryngopharyngitis.