Dyspnea

Case report:

A 49-year-old patient with clear medical history complained initially of dyspnea in April 2018, 3 days later an emergency intubation, respiration for 1 week. Under cortisone stabilized state, in June panendoscopy with presentation of a laryngeal edema. 3 days later tracheostomy due to increased laryngeal edema. In the further course exclusion of systemic sarcoidosis by internal clarification.

Results:

Laryngeal CT: wall thickening in the larynx. Laryngeal biopsy: findings of granulomatous laryngitis. Exclusion of a C1-esterase-inhibitor-deficiency and an allergic genesis. ACE, electrophoresis and all other laboratory parameters in the standard range. Exclusion of systemic sarcoidosis.

Summary:

In case of edematous supraglottic swelling laryngeal sarcoidosis should be considered after exclusion of other causes (malignant neoplasia, condition after radiotherapy, myxedema, amyloidosis, M. Wegener, infections) and the corresponding symptoms (dysphonia, dyspnea, dysphagia or globe sensation). If systemic involvement has been ruled out, histological evidence of granulomatous laryngitis should be considered indicative. If medical therapy (steroids, cytostatics, immunosuppressants) is insufficient a tracheotomy may be necessary in case of dyspnea.

Publication History

Publication Date:
12 June 2019 (online)