A rare manifestation of a multisystemic disease: a case of vocal cord palsy secondary to sarcoidosis

We describe a rare case of recurrent laryngeal nerve neuritis secondary to sarcoidosis. A 40-year-old woman presented with persistent dysphonia. This was her first episode of dysphonia with no reports of laryngeal trauma. Fibre-optic laryngoscopy revealed a normal nasal passage, nasopharynx and phar...

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Bibliographic Details
Published in:BMJ case reports 2015-04, Vol.2015, p.bcr2015209728
Main Authors: Mastan, Saleem, Advani, Rajeev, Stobbs, Nicola, Kumar, Nirmal
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Lymphatic Diseases - complications
Lymphatic Diseases - diagnosis
Lymphatic system
Medical imaging
Morphology
Neuritis - etiology
Otolaryngology
Pathology
Pulmonary arteries
Recurrent Laryngeal Nerve
Sarcoidosis
Sarcoidosis - complications
Sarcoidosis - diagnosis
Thorax
United Kingdom
Unusual Presentation of More Common Disease/Injury
Vocal Cord Paralysis - etiology
White
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Summary:We describe a rare case of recurrent laryngeal nerve neuritis secondary to sarcoidosis. A 40-year-old woman presented with persistent dysphonia. This was her first episode of dysphonia with no reports of laryngeal trauma. Fibre-optic laryngoscopy revealed a normal nasal passage, nasopharynx and pharynx. The supraglottic structures were all unremarkable; however, inspection of the true vocal cords revealed a left vocal cord palsy that was identified as being in a paramedian position. Radiological investigation showed mediastinal adenopathy that measured up to 20 mm in the short axis diameter. Histological examination showed granulomatous lymphadenitis of the lymph node with a central area of sclerosis surrounded by discrete, non-caseating granuloma. Stains for acid-fast bacilli were negative. The morphological features were suggestive of sarcoidosis. The lymphadenopathy distribution and size did not suggest left recurrent laryngeal nerve compression, giving a subsequent diagnosis of recurrent laryngeal nerve neuritis secondary to sarcoidosis.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-209728