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Idiopathic subglottic stenosis and the consequences in cardiopulmonary exercise testing
  1. Rick Verjans1,
  2. Sietske van Berkel1,
  3. Tom Brandon1 and
  4. Hans Grotjohan2
  1. 1Sports Medicine, Isala Zwolle, Zwolle, The Netherlands
  2. 2Pulmonary Medicine, Isala Zwolle, Zwolle, The Netherlands
  1. Correspondence to Dr Rick Verjans; r.j.h.verjans{at}isala.nl

Abstract

A 15-year-old male patient with progressive dyspnoea and exercise-related wheezing was analysed with spirometry, ECG and a cardiopulmonary exercise test with blood gas analysis. Earlier analysis by a paediatrician concluded no abnormalities. However, the previously performed spirometry test may have clarified the diagnosis in an earlier stage.

Severe hypoventilation was seen during the exercise test with hypercapnia and hypoxaemia while hearing a stridor during exercise. Eventually, a circular subglottic stenosis was seen on a CT scan of the chest. No malignancy or granulomatosis with polyangiitis was seen in biopsy and pathologic examination. There was no history of trauma, intubation or infection. Therefore, the diagnosis idiopathic subglottic stenosis was established. Bronchoscopic balloon dilation followed several times, leading to full recovery.

  • respiratory medicine
  • sports and exercise medicine

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Footnotes

  • Contributors RV and HG conceived of the presented case. HG was the primary treating physician. RV wrote the full text case report including figures. RV was responsible for communication between caretakers and the patient including his family. RV helped in retrieval of informed consent, reconstructing raw data of the cardiopulmonary exercise testing to figures, retrieval of follow-up information in the academic setting, retrieval of patients perspective and data collection and interpretation. SvB, TB and HG helped supervise the project, made critical review of the full text report including figures. All authors discussed the results and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.