[Airway manifestations of relapsing polychondritis: treatment with cyclophosphamide and placement of bronchial stents].
We report the case of a 41-year-old female patient with relapsing polychondritis and severe respiratory involvement. The patient presented with acute respiratory failure requiring endotracheal intubation. Bronchoscopy revealed tracheal collapse and inflammatory stenoses with dynamic collapse of the major airways. We describe a multidisciplinary therapeutic approach, consisting of immunosuppressive treatment, bronchoscopic placement of self-expandable stents into the collapsing bronchi, and tracheotomy. In addition, we report the effectiveness of oral cyclophosphamide for treatment of relapsing polychondritis with severe respiratory involvement after failure of other immunosuppressive agents. The problem of severe respiratory complications in patients with relapsing polychondritis and the need for a multidisciplinary approach is discussed.
Hellmich
B
B
Medizinische Klinik und Poliklinik, Rheumatologische Ambulanz, BG Kliniken Bergmannsheil, Universitätsklinik, Ruhr-Universität Bochum, Bürckle-de-la-Camp-Platz 1, 44789 Bochum. bernhard-hellmich@ruhr-uni-bochum.de
Hering
S
S
Duchna
H-W
HW
Schultze-Werninghaus
G
G
Freitag
L
L
Schatz
H
H
Meyer
M F
MF
D000328:Adult; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001999:Bronchoscopy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D010348:Patient Care Team; D011081:Polychondritis, Relapsing / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014140:Tracheotomy
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide