Segura Méndez Nora Hilda, Barragán Estrada María de la Luz, Paredes Delgado María de Lourdes, Torres Salazar Augusto Bernardo, Betancourt Hernández Lidia Angélica, Canizales Cobos Martín, Murillo Gómez Erika, Martínez Hernández Luis Enrique, Mora Nieto Alejandra
Médica adscrita al servicio de Alergia e Inmunología Clinica, Hospital de Especialidades Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, IMSS.
Rev Alerg Mex. 2006 Jan-Feb;53(1):30-3.
The laryngeal amyloidosis is an uncommon disease accounting for 1% of all benign lesions of larynx. The commonest symptom is the dysphonia, sometimes accompanied by stridor, laryngeal globus sensation, dysphagia and, in rare occasions, cough, dyspnea and hemoptysis, specially when the tracheobronchial tree is also affected. This paper describes the case of a 30-year-old female patient, whose main symptoms were progressive dysphonia and dyspnea, admitted at allergy service to rule out asthma. The respiratory function tests showed obstruction in the medium and small caliber ways without reversibility with salbutamol. Biopsies of ventricular band, vocal cord and arytenoid stained with positive Congo red for amyloid tissue, established the laryngeal amyloidosis diagnosis. The complementary studies to rule out amyloid tissue in the remaining tracheobronchial tree were negative. Dyspnea had characteristics of laryngeal origin, caused by a pulmonary ventilation disorder provoked by the difficult arrival of air to alveoli, which caused the decreased partial pressure of oxygen and CO2.
喉淀粉样变性是一种罕见疾病,占喉部所有良性病变的1%。最常见的症状是声音嘶哑,有时伴有喘鸣、咽喉部异物感、吞咽困难,在极少数情况下还会出现咳嗽、呼吸困难和咯血,特别是当气管支气管树也受到影响时。本文描述了一名30岁女性患者的病例,其主要症状为进行性声音嘶哑和呼吸困难,因怀疑哮喘入住过敏科。呼吸功能测试显示中小气道阻塞,使用沙丁胺醇后无可逆性。室带、声带和杓状软骨活检刚果红染色显示淀粉样组织阳性,确诊为喉淀粉样变性。排除其余气管支气管树淀粉样组织的补充检查结果为阴性。呼吸困难具有喉部起源的特征,是由空气难以到达肺泡导致肺通气障碍引起的,进而导致氧分压和二氧化碳分压降低。