Case report, case study

https://doi.org/10.20471/acc.2026.65.01.19

Endoscopic Management of Subglottic Stenosis in a Child with Granulomatosis with Polyangiitis

Mirta Peček ; Community Health Center Zagreb- West, Zagreb, Croatia *
Andro Košec ; Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospi- tal Center, Zagreb, Croatia
Maja Končić ; Department of Anesthesiology, Intensive Care Medicine and Pain Management, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Tomislav Gregurić ; Department of Radiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Bernardica Jurić ; Ljudevit Jurak Clinical Department of Pathology and Cytology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mandica Vidović ; Division of Clinical Immunology and Rheumatology, Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Siniša Stevanović ; Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia

* Corresponding author.

Abstract

Background: Granulomatosis with polyangiitis (GPA), formerly known as Wege-
ner’s granulomatosis, is a rare autoimmune disorder characterized by necrotiz-
ing vasculitis of small- to medium-sized vessels, most commonly affecting the
kidneys and respiratory tract. Airway involvement, particularly subglottic steno-
sis, is more frequently observed in pediatric patients and may present as stridor
or progressive dyspnea.
4
5
Methods: We report the case of a 12-year-old girl presenting with acute upper
airway obstruction. Emergency endoscopic surgery was performed without tra-
cheotomy, utilizing CO₂ laser excision in combination with local anti-inflamma-
tory therapy.
Results: Histopathology revealed granulation tissue without definitive granulo-
mas. Positive atypical perinuclear anti-neutrophil cytoplasmic antibodies (p-AN-
CA) supported the diagnosis of GPA. The patient responded favorably to system-
ic corticosteroid therapy, with a complete resolution of symptoms.
Conclusion: Although rare, GPA-related airway manifestations in children re-
quire prompt multidisciplinary evaluation. Early endoscopic intervention can be
effective and may obviate the need for tracheostomy.

Keywords

Granulomatosis with polyangiitis; Subglottic stenosis; Pediatric airway obstruction; p-ANCA; Endoscopic laser surgery

Hrčak ID:

345847

URI

https://hrcak.srce.hr/345847

Publication date:

27.3.2026.

Article data in other languages: croatian

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