A patient with relapsing polychondritis who had been diagnosed as intractable bronchial asthma.
A 62-year-old woman, diagnosed as bronchial asthma 3 years previously, was admitted due to acute severe dyspnea. Physical examination revealed saddle nose, flare/swelling of the ear auricles, and stridor. Computed tomography demonstrated thickening of tracheal/bronchial walls and stenosis of the lumen that deteriorated on expiration, suggesting tracheobronchomalacia. Auricle biopsy indicated cartilage destruction. Based on these findings, the patient was diagnosed as relapsing polychondritis. As demonstrated in this case, relapsing polychondritis involving airways might be misdiagnosed as bronchial asthma due to stridor and transient corticosteroid-related improvement. Early diagnosis is necessary to prevent irreversible airway stenosis and progression to tracheobronchomalacia.
Center for Pulmonary Diseases, National Hospital Organization Tokyo National Hospital, Japan.
Ryota
R
Sato
Nobuharu
N
Ohshima
Kimihiko
K
Masuda
Hirotoshi
H
Matsui
Naoko
N
Higaki
Eri
E
Inoue
Jun
J
Suzuki
Hideaki
H
Nagai
Shinobu
S
Akagawa
Akira
A
Hebisawa
Shunsuke
S
Shoji
D001249:Asthma / Q000175:diagnosis*; D003251:Constriction, Pathologic; D003951:Diagnostic Errors; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011081:Polychondritis, Relapsing / Q000175:diagnosis* / Q000188:drug therapy; D012135:Respiratory Sounds / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D055089:Tracheobronchomalacia / Q000175:diagnosis / Q000517:prevention & control
D008775:Methylprednisolone