Law Sarah, Pillai Jeni, Burgess Chris
Otolaryngology, Musgrove Park Hospital, Taunton, Somerset, UK
Health and Social Sciences, University of Bristol, Bristol, UK.
BMJ Case Rep. 2020 Feb 25;13(2):e233566. doi: 10.1136/bcr-2019-233566.
We present a case of a 72-year-old women who presented with a persistent sore throat and productive cough. On flexible nasendoscopy examination, she was found to have a fairly superficial ulcer affecting the laryngeal surface and tip of her epiglottis. On her second microlaryngoscopy and biopsy, direct immunofluorescent staining of the biopsy was analysed and the histological findings were in keeping with a diagnosis of mucous membrane pemphigoid (MMP). MMP is a rare chronic autoimmune condition characterised by the presence of blistering subepithelial lesions that can cause scarring. Laryngeal MMP affects only 1 in 10 million people and can lead to life-threatening airway compromise arising from scarring and stenosis. As there is a large spectrum of disease, it is important to adopt a multidisciplinary approach including dermatologists, otolaryngologists and ophthalmologists for prompt diagnosis and early recognition of potential complications, maximising functional outcomes for patients.
我们报告一例72岁女性病例,该患者表现为持续性咽痛和咳痰。在可弯曲鼻内镜检查中,发现她有一个相当表浅的溃疡,累及会厌的喉面和尖端。在她的第二次显微喉镜检查及活检中,对活检组织进行了直接免疫荧光染色分析,组织学结果符合黏膜类天疱疮(MMP)的诊断。MMP是一种罕见的慢性自身免疫性疾病,其特征是存在可导致瘢痕形成的上皮下疱性病变。喉MMP在每1000万人中仅影响1人,可导致因瘢痕形成和狭窄而危及生命的气道梗阻。由于该病的疾病谱广泛,采用包括皮肤科医生、耳鼻喉科医生和眼科医生在内的多学科方法对于及时诊断和早期识别潜在并发症、最大化患者的功能结局非常重要。