Kimura Yoshitaka, Asako Kurumi, Kikuchi Hirotoshi, Hoshimoto Kazufusa, Sasajima Yuko, Kono Hajime
Department of Internal Medicine, Teikyo University School of Medicine, Japan.
Intern Med. 2016;55(10):1363-6. doi: 10.2169/internalmedicine.55.5508. Epub 2016 May 15.
A 78-year-old man presented with bilateral auricular and nasal chondritis and an inner ear disorder. Relapsing polychondritis (RPC) was diagnosed and corticosteroid therapy was initiated. Two years later, he developed abdominal pain and a fever. A contrast-enhanced computed tomography scan showed enhancement of the mesentery and massive ascites. The patient underwent emergency laparotomy, which revealed inflammation and thickening of the omentum. A microscopic examination of the omentum disclosed vasculitis, and corticosteroid and cyclophosphamide pulse therapies were administered. We herein report the first case of RPC complicated by pathologically proven vasculitis of the omentum, clearly indicating an association between the pathogenesis of these two conditions.
一名78岁男性出现双侧耳廓及鼻软骨炎和内耳疾病。诊断为复发性多软骨炎(RPC)并开始使用皮质类固醇治疗。两年后,他出现腹痛和发热。增强计算机断层扫描显示肠系膜强化和大量腹水。患者接受了急诊剖腹手术,术中发现大网膜炎症和增厚。对大网膜进行显微镜检查发现血管炎,遂给予皮质类固醇和环磷酰胺冲击治疗。我们在此报告首例经病理证实的RPC合并大网膜血管炎病例,明确显示了这两种疾病发病机制之间的关联。