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We report the case of a patient presenting with recurrent tracheal stenosis secondary to anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis, refractory to conventional treatments. Despite multiple endoscopic dilatations and surgical resection of tracheal rings, disease control remained suboptimal. Introduction of sirolimus led to a sustained improvement of the stenotic lesion, as demonstrated by clinical and instrumental assessment. Sirolimus may be considered a valuable therapeutic option for severe subglottic inflammatory manifestations in ANCA-associated vasculitis.<\/jats:p>","DOI":"10.4081\/reumatismo.2025.1851","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:18:19Z","timestamp":1753885099000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful treatment of refractory tracheal stenosis complicating anti-neutrophil cytoplasm antibody-associated vasculitis with sirolimus"],"prefix":"10.4081","volume":"77","author":[{"given":"Giorgio","family":"Buscetta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Palumbo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Rizzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuliana","family":"Guggino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"13965","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.11.43"},{"key":"13966","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28848"},{"key":"13967","unstructured":"Bach \u00c1, Ambrus A, Iv\u00e1nyi B, T\u00f3bi\u00e1s Z, Alim Marvasti GH, Rov\u00f3 L. IgG4-related laryngeal disease as a possible cause of idiopathic subglottic stenosis: a case report. 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