Usui Y, Aoshima M, Nasu H, Tada H, Chonabayashi N, Matsusako M, Watanabe H, Doi O, Uekusa T, Saiki S
Division of Respirology, St. Luke's International Hospital, Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Sep;36(9):818-22.
A 40-year-old woman was admitted to our hospital presenting with dry cough, sore throat, and fever. Her right auricle was markedly swollen and her ocular conjunctiva were reddened, suggesting scleritis. A chest computed tomogram showed narrowing of the trachea due to enlarged mediastinal soft tissues. These clinical findings suggested the patient had relapsing polychondritis. A cartilage biopsy from her right auricle was taken to confirm the diagnosis. Pathological findings revealed loosening and dissolution of cartilage and infiltration of lymphocytes, which were consistent with relapsing polychondritis. Although prednisolone was given to the patient, her symptoms were not alleviated. Methylprednisolone pulse therapy and oral diaminodiphenylsulfone were added to the patient's treatment regimen. With this combination, her symptoms gradually subsided. Constriction of the airway has been cited as one of the prognostic factors in relapsing polychondritis. In view of the danger of sudden death caused by airway obstruction, close observation of the patient in this case was considered necessary.
一名40岁女性因干咳、咽痛和发热入院。她的右耳廓明显肿胀,眼结膜发红,提示巩膜炎。胸部计算机断层扫描显示由于纵隔软组织肿大导致气管狭窄。这些临床发现提示该患者患有复发性多软骨炎。对其右耳廓进行软骨活检以确诊。病理结果显示软骨疏松和溶解以及淋巴细胞浸润,这与复发性多软骨炎相符。尽管给予了患者泼尼松龙,但她的症状并未缓解。甲基泼尼松龙冲击疗法和口服二氨基二苯砜被添加到患者的治疗方案中。通过这种联合治疗,她的症状逐渐消退。气道狭窄被认为是复发性多软骨炎的预后因素之一。鉴于气道阻塞导致猝死的危险,认为有必要对该病例患者进行密切观察。