Quantitative evaluation of airway involvement in a patient with relapsing polychondritis using computed tomography

Journal: Nihon Rinsho Men'eki Gakkai Kaishi = Japanese Journal Of Clinical Immunology
Published:
Abstract

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.

Authors
Naoto Azuma, Yoshihiro Takada, Aki Nishioka, Chieri Kanda, Masahiro Sekiguchi, Masayasu Kitano, Takanori Kuroiwa, Naoaki Hashimoto, Kiyoshi Matsui, Tsuyoshi Iwasaki, Hajime Sano
Relevant Conditions

Relapsing Polychondritis