title: A 66-Year-Old Man With a Past History of Relapsing Polychondritis Presented With Right Upper Lobe Consolidation, Nodular Airway Lesions, and a Corticosteroid-Responsive Chronic Cough.
abstract: A 66-year-old male nonsmoker from Arizona was referred to our practice for evaluation of chronic cough. He had a history of biopsy-proven relapsing polychondritis manifesting as right auricular and nasal pain and swelling 9 months prior to presentation. The onset of his cough coincided with the diagnosis of relapsing polychondritis, and he was prescribed prednisone 90 mg/d, which promptly relieved his rheumatologic and respiratory symptoms. A chest radiograph, obtained prior to the initiation of therapy, was normal. Any attempts at decreasing the dose of the glucocorticoid to < 30 mg/d resulted in recurrence of the cough but not of the auricular or nasal symptoms. A second chest radiograph done 6 months before presentation, while the patient was receiving prednisone 20 mg/d, was normal as well. In anticipation of our evaluation, he stopped all glucocorticoids for 7 days. He was not receiving any other medications, and he had no history of an atopic diathesis.
authors.affiliation: Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA. Electronic address: Carlos.Martinez-Balzano@umassmemorial.org.
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Martínez-Balzano
authors.affiliation: Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Andres
authors.initials: A
authors.lastname: Sosa
authors.affiliation: Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Sean
authors.initials: S
authors.lastname: O'Reilly
authors.affiliation: Department of Pathology, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Yuna
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Division of Lung, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Richard
authors.initials: R
authors.lastname: Irwin
mesh_terms: D000368:Aged; D001706:Biopsy; D002908:Chronic Disease; D003371:Cough / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011081:Polychondritis, Relapsing / Q000150:complications* / Q000175:diagnosis; D011241:Prednisone / Q000627:therapeutic use*; D011657:Pulmonary Eosinophilia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D005938:Glucocorticoids; D011241:Prednisone