(A705) Autoimmunity and the Airway: What We Know About Anti-IgLON5 Disease-Induced Vocal Fold Paralysis

Introduction: Anti-IgLON5 disease, a rare autoimmune disease first described in 2014, often presents with laryngeal manifestations including vocal fold paresis or paralysis. However, it is frequently misdiagnosed as motor neuron disease, and its laryngeal involvement remains underrepresented in the literature. This study synthesizes current knowledge on Anti-IgLON5 disease, emphasizing its laryngeal impact and identifying opportunities for the Otolaryngologist to enhance diagnostic precision and patient outcomes.

Methods: This study was performed as a scoping review using Google Scholar. Search terms used were “larynx” AND “Anti-IgLON5.” Articles were eliminated that could not be accessed, were irrelevant, and were not in English. Articles were reviewed and details of presentations, treatments, and outcomes were collected and described. A case example from our own tertiary medical center was then added to the existing literature.

Results: Nineteen total articles were identified using our search method. Eleven were eliminated according to our eligibility criteria. The eight remaining articles were reviewed. We additionally added the case of a 79-year-old female who presented to our Laryngology Clinic with shortness of breath and stridor on 08/05/24, and was found to have weakness in vocal fold abduction. She underwent left posterior cordotomy and medial arytenoidectomy on 08/09/24, which provided temporary relief. When symptoms again worsened on 12/23/24, she was referred for neuromuscular evaluation. However, she deferred this evaluation, and then was urgently hospitalized for respiratory failure on 01/02/25. She agreed to a neuromuscular workup at that time, and was diagnosed with Anti-IgLON5 disease.

Conclusions: Anti-IgLON5 disease is an autoimmune disorder which poses a unique diagnostic challenge for Otolaryngologists, as its laryngeal manifestations can mimic more common neuromuscular disorders like ALS. Recognizing these subtle but critical signs is essential to prompt diagnosis and timely intervention, ultimately improving outcomes in this rare and often misunderstood condition.