Sato Ryota, Ohshima Nobuharu, Masuda Kimihiko, Matsui Hirotoshi, Higaki Naoko, Inoue Eri, Suzuki Jun, Nagai Hideaki, Akagawa Shinobu, Hebisawa Akira, Shoji Shunsuke
Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan.
Intern Med. 2012;51(13):1773-8. doi: 10.2169/internalmedicine.51.7621. Epub 2012 Jul 1.
A 62-year-old woman, diagnosed as bronchial asthma 3 years previously, was admitted due to acute severe dyspnea. Physical examination revealed saddle nose, flare/swelling of the ear auricles, and stridor. Computed tomography demonstrated thickening of tracheal/bronchial walls and stenosis of the lumen that deteriorated on expiration, suggesting tracheobronchomalacia. Auricle biopsy indicated cartilage destruction. Based on these findings, the patient was diagnosed as relapsing polychondritis. As demonstrated in this case, relapsing polychondritis involving airways might be misdiagnosed as bronchial asthma due to stridor and transient corticosteroid-related improvement. Early diagnosis is necessary to prevent irreversible airway stenosis and progression to tracheobronchomalacia.
一名62岁女性，3年前被诊断为支气管哮喘，因急性严重呼吸困难入院。体格检查发现鞍鼻、耳廓红肿及喘鸣。计算机断层扫描显示气管/支气管壁增厚及管腔狭窄，呼气时加重，提示气管支气管软化。耳廓活检显示软骨破坏。基于这些发现，该患者被诊断为复发性多软骨炎。如本病例所示，由于喘鸣和短暂的皮质类固醇相关改善，累及气道的复发性多软骨炎可能被误诊为支气管哮喘。早期诊断对于预防不可逆的气道狭窄和进展为气管支气管软化是必要的。
