A 72-year-old male patient with a history of severe smoking, chronic obstructive pulmonary disease, centrilobular emphysema, ischemic heart disease, and low-grade follicular non-Hodgkin's lymphoma stage IV A, who did not require treatment.
She presented three episodes of sudden dyspnea, which began with stridor of the larynx, dysphonia and high wheezing that required hospitalization in an intensive care unit associated with cough in two occasions.
The three episodes were self-limited from 30 minutes to one hour.
She never presented with cramping or desaturation.
During the second episode, a laryngoscopy showed edematous vocal cords, inspiration glottal closure with a small lumen in a posterior glotis and progressive improvement after fibrotic closure was performed.
Signs of malignancy.
A functional respiratory study (FRS) was performed in the acute phase, which showed the classic drawer in the inspiratory curve.
A series of esophagogastroduodenal (EGD) showed moderate GER.
It should be noted that the patient did not have the classic symptoms of GER.
Laryngeal or tracheal involvement due to lymphoma, thromboembolic disease, pulmonary or cardiac disease was ruled out.
Blood tests were normal.
After the first episode, she started treatment with corticosteroids, long-term inhaled beta 2 and tiotropium 18 μg/day, in addition to voice rehabilitation treatment or diological treatment.
No psychological support was provided.
After a second episode with the diagnosis of GER initiated 40 mg/day and domperidone 10 mg every 12 hours, the patient developed dyspnoea every 12 hours, presenting the third episode.
After the latter and with the medication mentioned, the patient has been asymptomatic for 10 months.
