Chronic laryngitis - an interdisciplinary challenge

Introduction Crohn’s disease is an inflammatory gastrointestinal disease of unknown origin which most commonly affects the terminal ileum and the colon. It usually begins in the early adulthood and is characterized by pain in the lower abdomen, diarrhea and weight loss. The treatment consists of corticosteroids and immunomodulators. Besides of gastrointestinal symptoms, extraintestinal manifestations occure in up to 50 % of the cases including the musculosceletal, dermal and ocular system. A laryngeal involvement, with only 12 in the literature reported cases since 1972, is a rare condition.

Case report A 43-year-old woman presented at the ENT department with recurrent laryngitis, high-grade dysphonia and increasing exercised-induced dyspnea. Furthermore, because of Crohn’s disease she received subcutaneous 40 mg of Adalimumab twice a week. Rigid laryngeal endoscopy revealed a synechia of the anterior commissure with signs of chronic inflammatory laryngitis. Histological examination revealed a chronic inflammation with ulceration and granulation tissue consistent with the diagnosis of Crohn’s disease. By use of inhalation with corticosteroids twice a day symptoms and local findings significantly improved.

Conclusion Non-caseating granulomas and giant cells are typical for Crohn’s disease. They can only be found in 20-40 % of the cases. Besides laryngeal manifestations, especially oral and nasal lesions are of great interest for an ENT specialist and should be considered.

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Publication History

Article published online:
07 August 2020