A case of relapsing polychondritis diagnosed with FDG-PET and controlled by positive airway pressure ventilation and immunosuppressive therapy
So Takata Masanari Hamaguchi Kentarou Masuhiro Taisei Umakoshi Kazunori Shimizu Hiroto Matsuoka
Department of Respiratory Medicine, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center
A 72-year-old man complaining of left shoulder pain and fever, without respiratory symptoms was referred to our hospital. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was performed for the determination of malignant disease and revealed uptake in the larynx and the trachea. He was finally diagnosed with relapsing polychondritis (RP) following auricular cartilage biopsy. Steroid therapy ameliorated the symptoms caused by RP. We planned to induce an immunosuppressive agent. However, before starting immunosuppressive therapy, RP recurred and he then presented with obstructive pneumonia and hypercapnic respiratory failure. After initiation of noninvasive positive pressure ventilation, dose escalation of steroids, and addition of an immunosuppressive agent, airway inflammation due to RP subsided and his respiratory condition stabilized.
Relapsing polychondritis (RP) Immunosuppressive agent Airway involvement
Received 18 May 2018 / Accepted 15 Jan 2019
AJRS, 8(3): 209-215, 2019