Dr. Pagnoux, et al reply

To the Editor: We appreciate the comments by Drs. Garcia-Valladares and Espinoza1 regarding our study on granulomatosis with polyangiitis (Wegener’s, GPA) persistently localized to one organ2. As emphasized by their patient’s case, subglottic stenosis often evolves and can relapse as a limited process in GPA, in the absence of or with only a few other active systemic extra-respiratory tract vasculitis manifestation(s) and/or progress to fibrotic stenosis. Most of these patients with this potentially rapidly life-threatening manifestation represent a difficult therapeutic challenge3. Because the response of subglottic stenosis to conventional systemic treatments is, at best, partial and, if so, often only transient, local therapy, … Address correspondence to Dr. Pagnoux; E-mail: christian.pagnoux{at}cch.aphp.fr