GPA is a rare autoimmune disease that causes inflammation in small blood vessels throughout the body, especially in the lungs, kidneys, sinuses, and airway. When it affects the voice box (larynx), it usually causes subglottic stenosis, or narrowing just below the vocal cords. This can lead to hoarseness, noisy breathing (stridor), shortness of breath, or frequent throat infections. Symptoms can build slowly, and it may first look like stubborn laryngitis. Because GPA is a systemic disease, it’s usually treated with oral steroids, immune-suppressing pills, and sometimes biologic drugs (prescribed by a rheumatologist). In our office, we can help manage the laryngeal symptoms with in-office steroid injections and airway dilations to open the narrowed area. In more advanced cases, a surgical airway procedure may be needed, though we try to avoid that with early intervention.