{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:14:20Z","timestamp":1756383260692,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,22]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Chronic non-granulomatous supraglottitis (CNGS) is a rare disorder of the supraglottic larynx, characterised by chronic supraglottic inflammation in the absence of granulomata, vasculitis, neoplasia, autoimmune disease or infective changes on histology. We present the case of a male adolescentwho attended with progressively worsening exertional dyspnoea, stridor and symptoms of obstructive sleep apnoea. Flexible nasendoscopy revealed marked supraglottic subepithelial thickening sparing the glottis and subglottis, confirmed on microlaryngoscopy. MRI of the head and neck demonstrated diffuse, homogenous supraglottic oedema. At the peak of his symptomology, the patient was admitted for further investigations and intravenous steroid therapy, and switched to prolonged oral steroids on discharge. Tracheostomy was avoided. After 3\u2009months, he was successfully weaned from steroids to azathioprine with gradual symptomatic improvement. This case represents the first successful use of a steroid-sparing agent in the management of CNGS.<\/jats:p>","DOI":"10.1136\/bcr-2018-227458","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T04:24:34Z","timestamp":1554351874000},"page":"e227458","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Chronic non-granulomatous supraglottitis of a male adolescent and its successful management with azathioprine"],"prefix":"10.1136","volume":"12","author":[{"given":"Aaron","family":"Kovacs","sequence":"first","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shankar","family":"Haran","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Paddle","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,3]]},"reference":[{"key":"2025082708144403000_12.4.e227458.1","first-page":"4","article-title":"Chronic nongranulomatous epiglottitis","volume":"67","author":"Friedman","year":"1988","journal-title":"Ear Nose Throat J"},{"key":"2025082708144403000_12.4.e227458.2","first-page":"3","article-title":"Unusual chronic epiglottis inflammation [in German]","volume":"104","author":"Schrottenbaum","year":"1963","journal-title":"Zentralbl Allg Pathol"},{"key":"2025082708144403000_12.4.e227458.3","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1017\/S0022215112000977","article-title":"Chronic non-granulomatous supraglottitis: a rare and difficult disease","volume":"126","author":"Ledgerwood","year":"2012","journal-title":"J Laryngol Otol"},{"key":"2025082708144403000_12.4.e227458.4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.ijporl.2019.02.031","article-title":"CO2 laser supraglottic resurfacing for non-granulomatous chronic supraglottitis in two children","volume":"120","author":"Smith","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"2025082708144403000_12.4.e227458.5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0030-6665(20)32417-8","article-title":"Medical and surgical aspects of the granulomatous diseases of the larynx","volume":"12","author":"Caldarelli","year":"1979","journal-title":"Otolaryngol Clin North Am"},{"key":"2025082708144403000_12.4.e227458.6","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200403000-00031"},{"key":"2025082708144403000_12.4.e227458.7","doi-asserted-by":"publisher","DOI":"10.1136\/adc.87.2.93"},{"key":"2025082708144403000_12.4.e227458.8","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/S1808-8694(15)30155-5","article-title":"Steroid injection in chronic inflammatory vocal fold disorders, literature review","volume":"74","author":"Campagnolo","year":"2008","journal-title":"Braz J Otorhinolaryngol"},{"key":"2025082708144403000_12.4.e227458.9","unstructured":"Oswal V , Remacle M , Jovanvic S , Zeitels SM , Krespi JP , Hopper C , et al . eds. 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