A case of relapsing polychondritis involving placement of an expandable metallic stent.
Relapsing polychondritis is a relatively uncommon disease characterized by recurrence of progressive inflammation of cartilaginous structures. Laryngotracheal involvement occurs in 50-70% of cases, and occasionally results in acute airway obstruction. We reported a case of relapsing polychondritis with severe tracheal stenosis that was treated by the placement of two expandable metallic stents. A 58-year-old man was hospitalized with fever and breathing difficulties. A tracheostomy was performed and a silicone T-tube was placed. A diagnosis of relapsing polychondritis was made based on the biopsy from auricular and tracheal cartilages. Two expandable metallic stents were placed in the trachea to bilateral main bronchus. This dilated the airway lumen and resulted in the dyspnea disappearing completely. However, 18 months later a sudden massive hemorrhage occurred through the tracheostoma, and he died of respiratory failure. Autopsy showed a tracheoinnominate artery fistula. We discuss the management of relapsing polychondritis with severe tracheal stenosis.
Nobukiyo
Shigenori
S
Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, 216-8511, Kawasaki, Japan. nobukiyo@marianna-u.ac.jp
Iwatake
Hiroya
H
Watanabe
Shoji
S
Akao
Ichiro
I
Tomisawa
Hideo
H
Koizuka
Izumi
I
D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000628:therapy; D016122:Brachiocephalic Trunk / Q000293:injuries / Q000473:pathology; D017809:Fatal Outcome; D005402:Fistula; D006801:Humans; D008297:Male; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011859:Radiography; D015607:Stents / Q000009:adverse effects; D014133:Tracheal Diseases / Q000473:pathology; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D014139:Tracheostomy; D016157:Vascular Fistula / Q000473:pathology