[Quantitative evaluation of airway involvement in a patient with relapsing polychondritis using computed tomography].
A 63-year-old woman was admitted to our hospital because of auricular chondritis, conjunctivitis, polyarthralgia, productive cough and dyspnea. On admission, pulmonary function test demonstrated an obstructive pattern, and flow-volume curve (FVC) revealed a constrictive upper airway flow pattern. Chest CT showed a thickened tracheal wall and narrowing of the airway. The laboratory findings revealed an elevation of CRP and high titer of anti-type II collagen antibody. She was diagnosed as relapsing polychondritis (RP) according to Damiani's criteria. After the initiation of the therapy with 32 mg/day of methylprednisolone, her symptoms, pulmonary function, FVC and CT findings ameliorated promptly, and the titer of anti-type II collagen antibody became normalized. Moreover, we measured the airway wall thickness, percentage wall area (WA%) and percentage wall thickness (WT%), by CT and HRCT, and also evaluated the airway involvement quantitatively. Both WA% and WT% were inversely correlated with FEV1.0%. The airway inlolvement is most important prognostic factor in patients with RP, and sequential evaluation of airway manifestation are necessary. We suggest that a quantitative evaluation of bronchial structures by sequential CT is useful for the evaluation of RP as well as pulmonary function tests.
Azuma
Naoto
N
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Takada
Yoshihiro
Y
Nishioka
Aki
A
Kanda
Chieri
C
Sekiguchi
Masahiro
M
Kitano
Masayasu
M
Kuroiwa
Takanori
T
Hashimoto
Naoaki
N
Matsui
Kiyoshi
K
Iwasaki
Tsuyoshi
T
Sano
Hajime
H
D001995:Bronchography; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D008775:Methylprednisolone