Mouth and genital ulcers with inflamed cartilage (MAGIC)‎ syndrome in pregnancy

Abstract EN

A thirty-three-year-old Jordanian female attended the ear, nose, and throat (ENT) clinic with hoarseness of voice and cough.

She had a history of repeated attacks of hoarseness and difficulty of breathing; these symptoms responded to oral steroids.

No definite diagnosis was made; however, asthma was contemplated.

Airway inflammation and crusting were detected during clinical examination, suggesting rhinoscleroma.

She was found to be pregnant and her steroid treatment was stopped.

After 1 week, she presented with upper airway obstruction necessitating emergency tracheotomy.

Review of her history revealed recurrent mouth and genital ulcers.

Bronchoscopy and biopsy revealed inflamed cartilage.

CT scan and flexible bronchoscopy revealed significant subglottic stenosis.

The patient was initially treated with steroids, and Azathioprine.

Postpartum, the patient was reassessed.

She underwent dilatation of the stenosed segment multiple times, after which, her tracheostomy was capped and subsequently closed.

MAGIC syndrome is a rare disease and is especially challenging when it presents in pregnancy.

Our patient considered abortion, but she was successfully managed with steroids and Azathioprine.