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October 1992

Autoantibodies Against Constituents of Neutrophils in the Diagnosis and Treatment of (Isolated) Subglottic Stenosis

Author Affiliations

From the Departments of Otolaryngology (Drs de Vries and Snow) and Internal Medicine (Drs Gans and Donker), the Free University Hospital Amsterdam, the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam (Dr Goldschmeding), and the Department of Medicine, Catharina Hospital, Eindhoven (Dr Hoorntje), the Netherlands.

Arch Otolaryngol Head Neck Surg. 1992;118(10):1120-1123. doi:10.1001/archotol.1992.01880100112021

• Six patients had a subglottic stenosis either as a presenting symptom or as a manifestation of a systemic disease. All patients had in common the presence of circulating autoantibodies against constituents of neutrophils on indirect immunofluorescence. Cytoplasmic and perinuclear staining patterns were recognized. Such autoantibodies have been reported in Wegener's granulomatosis, microscopic polyarteritis, (idiopathic) glomerulonephritis, and Churg-Strauss syndrome. However, only one of the six patients fulfilled the criteria for these conditions. Because a positive test for autoantibodies against constituents of neutrophils is rare in other conditions and because other diseases had been excluded, we suggest that this places subglottic stenosis within the spectrum of necrotizing (granulomatous) vasculitis. The consequences for therapy are discussed.

(Arch Otolaryngol Head Neck Surg. 1992;118:1120-1123)

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