Bronchoscopic Management of Tracheobronchial Stenosis Secondary to Granulomatosis with Polyangitis: A Case Report

Granulomatosis with Polyangitis (GPA), previously known as Wegener’s Granulomatosis, is a form of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vascuilitis predominantly involving the upper and lower respiratory tract and kidneys. Tracheobronchial involvement in GPA can have varied manifestations which include airway inflammation, mucosal granulomas, tracheobronchial stenosis, tracheal and endobronchial mass lesions (inflammatory pseudo tumors), tracheobronchomalacia and tracheoesophageal fistulae [1-3]. Tracheobronchial involvement is seen in nearly 30 to 50% of the cases [1,4]. The subglottic portion of the trachea is most commonly affected [5]. Management of tracheobronchial GPA is complex, including endoscopic and surgical approach. The management of lower tracheal and bronchial stenosis is less reported than subglottic stenosis in tracheobronchial GPA.