Total intravenous anesthesia with propofol-ketamine-xylazine with or without remifentanil in thoroughbred horses undergoing castration.

OBJECTIVES

Both antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and relapsing polychondritis (RP) are rare diseases. Distinguishing between the two becomes particularly challenging when airway involvement is the predominant clinical manifestation. We informed to compare airway imaging features and surgical outcomes between AAV and RP.

METHODS

We retrospectively analysed 56 patients (29 AAV patients and 27 RP patients) with airway involvement who underwent neck and chest thin-section computed tomography (CT). We compared the two groups in terms of clinical manifestations, imaging findings, and surgical outcomes.

RESULTS

RP patients were younger at onset. In AAV patients, involvement predominantly occurred in the distal bronchi (86%), with parenchymal lung disease being the most frequent manifestation (83%). RP patients more frequently been involved of the subglottic region (89%) and cervical trachea (74%) and tended to have more extensive airway involvement. RP patients more often exhibited airway wall thickening, luminal stenosis, and wall calcification. In addition, among those requiring tracheostomy, successful decannulation after medical treatment was achieved in 86% (6/7) of AAV patients but only 30% (3/10) of RP patients.

CONCLUSIONS

AAV preferentially involves the distal bronchi, whereas RP predominantly affects the central airways and is frequently associated with persistent structural airway damage. Taken together, this study characterises the clinical and CT imaging features of airway involvement in AAV and RP and may provide preliminary reference for the clinical differentiation and individualised management of airway disease in these two conditions.