Niju Takashi, Tsuruta Naotoshi, Kuhara Hanako, Saito Yoshiyuki, Hara Hideki
Department of Respiratory Medicine, Nishinomiya Municipal Central Hospital.
Nihon Kokyuki Gakkai Zasshi. 2008 Mar;46(3):220-5.
A 57-year-old man was admitted to our hospital with hoarseness, productive cough, and dyspnea. Chest CT revealed a thickening of the tracheal wall, and the flow-volume curve showed a constrictive upper airway flow pattern. Bronchoscopy revealed disappearance of cartilaginous rings and tracheal stenosis. Biopsy of the cricoid cartilage showed findings compatible with relapsing polychondritis and a diagnosis of relapsing polychondritis was made in accordance with Damiani's criteria. The flow-volume curve and symptoms were immediately improved by methylprednisolone pulse therapy, but on reduction of oral prednisorone, recurrence was identified by flow-volume curve and bronchoscopy. Administration of dapson and cyclophosphamide in addition to oral prednisolone after intravenous methylprednisolone and flow-volume curve resulted in improvement. In this case, monitoring of flow-volume curve was useful for the evaluation of airway complication in relapsing polychondritis.
一名57岁男性因声音嘶哑、咳痰和呼吸困难入院。胸部CT显示气管壁增厚,流量-容积曲线显示上气道呈狭窄型气流模式。支气管镜检查显示软骨环消失和气管狭窄。环状软骨活检结果符合复发性多软骨炎,根据达米亚尼标准诊断为复发性多软骨炎。甲基强的松龙脉冲治疗后,流量-容积曲线和症状立即改善,但口服泼尼松减量后,通过流量-容积曲线和支气管镜检查发现复发。静脉注射甲基强的松龙后,除口服泼尼松外,加用氨苯砜和环磷酰胺并结合流量-容积曲线监测,症状得到改善。在该病例中,流量-容积曲线监测有助于评估复发性多软骨炎的气道并发症。