Rheumatoid Nodules of the Vocal Cords as the Initial Manifestation of Systemic Lupus Erythematosus

INVOLVEMENT of the larynx in rheumatoid disease is not rare and is most commonly manifested as cricoarytenoid joint arthritis. While not symptomatic in all cases, it has been present in almost 50% of autopsies of patients with rheumatoid disease.¹ Less frequently, symptoms are due to laryngeal myositis or neuropathy of the recurrent laryngeal nerve, attributed to rheumatoid vasculitis.² There have been relatively few documented cases of rheumatoid nodule formation involving the vocal cords or other parts of the larynx.^2-5 These have been limited to patients with a previously established diagnosis of rheumatoid arthritis at the time of laryngeal symptomatology. We recently diagnosed rheumatoid granulomas on vocal cord biopsy material from a patient who had no evidence of rheumatoid disease or other connective tissue disorder at the time. During follow-up, she showed development of manifestations of systemic lupus erythematosus (SLE).

Report of a Case  A 28-year-old woman complained