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以声音嘶哑和多系统受累为表现的复发性多软骨炎:诊断与治疗挑战

Relapsing Polychondritis Presenting With Hoarseness and Multisystem Involvement: A Diagnostic and Therapeutic Challenge.

作者信息

De Silva Shamilka, De Silva Monika, De Silva Pradeep K

机构信息

Internal Medicine, National Hospital of Sri Lanka, Colombo, LKA.

Rheumatology, National Hospital of Sri Lanka, Colombo, LKA.

出版信息

Cureus. 2024 Nov 30;16(11):e74874. doi: 10.7759/cureus.74874. eCollection 2024 Nov.

DOI:10.7759/cureus.74874
PMID:39741616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11685328/
Abstract

Relapsing polychondritis (RP) is a rare autoimmune disorder characterized by recurrent inflammation of cartilaginous tissues throughout the body, particularly the ears, nose, eyes, joints, and the respiratory tract. We present a case of a 68-year-old female without previous comorbidities who presented with gradually progressive hoarseness of voice and inflammatory polyarthritis, nasal and ear involvement eventually leading to the diagnosis of RP with concurrent osteoporosis. The diagnosis was made based on Modified McAdam criteria, highlighting the significance of clinical evaluation in guiding diagnosis and treatment decisions. Treatment with intravenous cyclophosphamide and oral prednisolone resulted in significant improvement in symptoms and inflammatory markers. Osteoporosis was managed with intravenous zoledronic acid. This case underscores the importance of considering RP in the differential diagnosis of patients presenting with hoarseness of voice and multisystem involvement, even in the absence of histological confirmation.

摘要

复发性多软骨炎(RP)是一种罕见的自身免疫性疾病,其特征是全身软骨组织反复发炎,尤其是耳朵、鼻子、眼睛、关节和呼吸道。我们报告一例68岁女性病例,该患者既往无合并症,表现为逐渐进展的声音嘶哑和炎性多关节炎,鼻和耳受累,最终诊断为RP并伴有骨质疏松症。诊断基于改良的麦克亚当标准,强调了临床评估在指导诊断和治疗决策中的重要性。静脉注射环磷酰胺和口服泼尼松龙治疗使症状和炎症指标有显著改善。骨质疏松症采用静脉注射唑来膦酸治疗。该病例强调了在鉴别诊断声音嘶哑和多系统受累的患者时考虑RP的重要性,即使在没有组织学确诊的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/749fcfa8c1c6/cureus-0016-00000074874-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/f85f3c45463e/cureus-0016-00000074874-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/313b9655b0a4/cureus-0016-00000074874-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/749fcfa8c1c6/cureus-0016-00000074874-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/f85f3c45463e/cureus-0016-00000074874-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/313b9655b0a4/cureus-0016-00000074874-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62bc/11685328/749fcfa8c1c6/cureus-0016-00000074874-i03.jpg

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