Yanagihara Toyoshi, Ohgushi Migiwa, Setoguchi Taro, Ogo Naruhiko, Inutsuka Yu, Fujiwara Haruna, Asoh Tatsuma, Sunami Syunya, Yoneda Reiko, Maeyama Takashige
Department of Respiratory Medicine, Hamanomachi Hospital, Fukuoka, JPN.
Department of General Medicine, Hamanomachi Hospital, Fukuoka, JPN.
Cureus. 2022 Jan 20;14(1):e21463. doi: 10.7759/cureus.21463. eCollection 2022 Jan.
We describe the case of a 60-year-old Japanese man with relapsing polychondritis (RP). The patient was referred to Hamanomachi Hospital due to mild elevation of C-reactive protein and mild anemia on medical checkup without any symptoms. Body CT imaging showed thickened tracheal and bronchial walls with no active lesions in the lung. Precise physical examination revealed swelling in both ears. Bronchoscopy revealed redness and swelling of the tracheal and bronchial mucosa in the membranous lesion. Histologic examination of the bronchial biopsy showed inflammatory cell infiltration in the sub-mucosa with no vasculitis. Serum anti-type 2 collagen antibodies were found to be positive (33.9 EU/mL). Corticosteroid treatment improved his tracheochondritis. It is challenging to diagnose RP in the early stage due to its rarity and nonspecific symptoms. Airway involvement in RP is irreversible and the major cause of morbidity and mortality; hence, early recognition of airway involvement and treatment is warranted.
我们描述了一例60岁日本男性复发性多软骨炎（RP）患者的病例。该患者因体检时C反应蛋白轻度升高和轻度贫血而被转诊至滨之町医院，当时无任何症状。身体CT成像显示气管和支气管壁增厚，肺部无活动性病变。详细的体格检查发现双耳肿胀。支气管镜检查显示膜性病变处气管和支气管黏膜红肿。支气管活检的组织学检查显示黏膜下层有炎性细胞浸润，无血管炎。血清抗2型胶原抗体呈阳性（33.9 EU/mL）。皮质类固醇治疗改善了他的气管软骨炎。由于RP罕见且症状不具特异性，早期诊断具有挑战性。RP累及气道是不可逆的，是发病和死亡的主要原因；因此，有必要早期识别气道受累情况并进行治疗。
