Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
Chest. 2015 Nov;148(5):e142-e147. doi: 10.1378/chest.15-0498.
A 66-year-old male nonsmoker from Arizona was referred to our practice for evaluation of chronic cough. He had a history of biopsy-proven relapsing polychondritis manifesting as right auricular and nasal pain and swelling 9 months prior to presentation. The onset of his cough coincided with the diagnosis of relapsing polychondritis, and he was prescribed prednisone 90 mg/d, which promptly relieved his rheumatologic and respiratory symptoms. A chest radiograph, obtained prior to the initiation of therapy, was normal. Any attempts at decreasing the dose of the glucocorticoid to < 30 mg/d resulted in recurrence of the cough but not of the auricular or nasal symptoms. A second chest radiograph done 6 months before presentation, while the patient was receiving prednisone 20 mg/d, was normal as well. In anticipation of our evaluation, he stopped all glucocorticoids for 7 days. He was not receiving any other medications, and he had no history of an atopic diathesis.
一位来自亚利桑那州的 66 岁男性非吸烟者，因慢性咳嗽就诊于我院。他在就诊前 9 个月有复发性多软骨炎的活检证实病史，表现为右耳和鼻痛和肿胀。他的咳嗽发作与复发性多软骨炎的诊断同时发生，他接受了泼尼松 90 mg/d 的治疗，这迅速缓解了他的风湿和呼吸道症状。在开始治疗前获得的胸部 X 线片正常。任何试图将糖皮质激素剂量减少到<30 mg/d 的尝试都导致咳嗽复发，但耳部或鼻部症状没有复发。在就诊前 6 个月拍摄的第二次胸部 X 线片，当时患者接受泼尼松 20 mg/d 的治疗，也正常。在我们评估之前，他停止了所有糖皮质激素治疗 7 天。他没有服用任何其他药物，也没有特应性体质的病史。
