Clinical manifestations of autoimmune rheumatic diseases in the larynx

Abstract

Introduction. Autoimmune rheumatic diseases are attributed to a systemic process that develops in many organs, including the larynx. Complaints of impaired vocal function in patients with this pathology require a thorough clinical and endoscopic analysis.The purpose of the study. To determine the clinical-endoscopic changes of the larynx in patients with impaired vocal function in autoimmune rheumatic diseases..Materials and methods. 31 (100%) patients aged 25 to 84 (41 ± 15) years with autoimmune rheumatic diseases applied to the phoniatric department of the St. Petersburg Research Institute of ENT. There were 3 men (10%), 28 women (90%). All patients complained of impaired vocal function, 5 of the examined (16%) were also concerned about breathing disorders during exercise or at rest.Patients were grouped into three groups: systemic lupus erythematosus 4 (13%) people, systemic vasculitis 10 (32%) people, rheumatoid arthritis 17 (55%) people.Videolaryngoscopy, videolaryngostroboscopy, autofluorescence endoscopy, NBI – endoscopy (according to indications) were used to make the diagnosis.Results. The distribution of laryngeal pathology by nosological forms in patients with аutoimmune rheumatic diseases was as follows. The most numerous were groups with functional dysphonia of the hypotonic type 10 (32%) and bamboo nodules of 8 (26%) patients. Chronic laryngeal stenosis was diagnosed in 5 (16%), and chronic catarrhal laryngitis and soft nodules of the vocal folds in 3 (9.5%) people in each group (respectively). The smallest number of patients suffered from ulcerative necrotic changes of the larynx and pharynx – 2 (7%).Conclusion. Thus, laryngeal changes in аutoimmune rheumatic diseases had both specific manifestations and non-specific ones. The latter include functional dysphonia of the hypotonic type, chronic catarrhal laryngitis, soft nodules of the vocal folds. Bamboo nodules of the vocal folds, ulcerative necrotic diseases, chronic laryngeal stenosis (infiltrative and scarring) were specific for patients with аutoimmune rheumatic diseases.