The involvement of upper airway in Wegener's granulomatosis - about four cases.

The authors present four cases of Wegener's granulomatosis patients with multiorganic manifestation forms, but with a prevalent involvement in upper-airway. Granulomatosis diseases of the nose include bacterial infections (rhinoscleroma, tuberculosis, syphilis, lupus, and leprosy), fungal infections (rhinosporidiosis, aspergillosis, mucormycosis, candidosis, histoplasmosis, and blastomycosis) and diseases with unspecified etiology (Wegener's granulomatosis, mediofacial malignant granuloma, and sarcoidosis). We consider an interesting experience regarding Wegener's granulomatosis due to its rarity, being an autoimmune systemic disease, with continuous evolution and multiorganic involvement. The beginning of the disease is like upper airway affection, a kind of "persistent cold", being difficult to differentiate it from a common cold in the head, with a prolonged evolution. It is important to mention that we establish the diagnosis of Wegener's granulomatosis starting with Ear Nose and Throat (ENT) clinical exam, followed by other tests and investigations realized in our Clinic and completed with specialty tests (nephrology, internal medicine and dermatology), meaning that we need a close cooperation with these medical specialties. All the patients presented multiorganic involvement. Notably significant for our four cases is the prolonged evolution in a stable condition in one patient.

Hanseníase dimorfa com padröes diversos de reaçäo granulomatosa em pele e vísceras / Borderline leprosy with several patterns of granulomatous reactions in skin and visceras

Um paciente com história de no mínimo 12 anos de evoluçao, considerado como portador de Hanseníase virchoviana e com todas as seqüelas características (madarose, queda de pirâmide nasal, fibrose e atrofia dos testículos) além de episódios de Eritema nodoso hansênico, apresenta padroes diversos de reaçao granulomatosa em pele, nervos e vísceras. Observa-se granulomas virchovianos ativos, granulomas virchovianos regressivos, granulomas dimorfos difusos, e granulomas com padrao tuberculóide na presença de rica baciloscopia incluindo bacilos típicos. O aspecto mais interessante é o encontro de granulomas tuberculóides múltiplos em linfonodos, medula óssea, fígado e baço. A rica baciloscopia e a presença de bacilos típicos, apesar do predomínio de reaçao granulomatosa de padrao tuberculóide fala a a favor de uma piora da doença. Discute-se a interpretaçao imunológica deste tipo de reaçao e sua relaçao com a má evoluçao do paciente.

Leprosy in ENT.

Two cases of leprosy are reported, one of which was admitted as a case of acute tonsillitis and was referred only later to the ENT surgeons with hoarseness after a diagnosis had been made by biopsy of the lymph node; the other was referred with a possible facial paralysis. This is a rare diagnosis but it should still be kept in mind, particularly in the immigrant population of the United Kingdom and Saudi Arabia and particularly of the Saudis from the southern provinces.

Leprosy of the larynx: a clinicopathological study.

Ten established cases of lepromatous leprosy with laryngeal involvement are reported, and their clinical and histopathological findings are discussed with a brief review of the literature.

A clinico-pathological study of laryngeal lesions in 30 cases of leprosy.

The histological findings in laryngeal biopsies and local clinical findings in thirty cases of leprosy have been reported in detail. It is emphasised that in areas where there is significant incidence of leprosy, laryngeal involvement may be expected even in the absence of local clinical manifestations and be got confirmed by histological examination and demonstration of acid-fast bacilli. Further, histological appearance may not be very characteristic at the outset. The observations made by previous authors have been reviewed and discussed.

A clinico-pathological study of laryngeal lesions in 30 cases of leprosy

The histological findings in laryngeal biopsies and local clinical findings in thirty cases of leprosy have been reported in detail. It is emphasised that in areas where there is significant incidence of leprosy, laryngeal involvement may be expected even in the absence of local clinical manifestations and be got confirmed by histological examination and demonstration of acid-fast bacilli. Further, histological appearance may not be very characteristic at the outset. The observations made by previous authors have been reviewed and discussed.

Leprosy of the upper respiratory tract. A clinical bacteriological, histopathological and histochemical study of twenty cases.

Twenty cases clinically diagnosed as leprosy were thoroughly examined for E.N.T. lesions. These lesions were subjected to bacteriological, histopathological and histochemical studies. The results have been tabulated and discussed with special stress on some findings which are of help in diagnosing the disease.

Leprosy of the larynx.

Five instances of lepromatous leprosy involving lesions of the larynx were encountered among a series of 280 laryngeal lesions. These are briefly described as involving the epiglottis in all cases, vocal cords in two, and extension into the pyriform fossa in one instance.