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Takigawa Y, Sato K, Kudo K, Ichikawa T, Sasano Y, Matsumoto S, Inoue T, Fujiwara M, Matsuoka S, Watanabe H, Sato A, Fujiwara K, Shibayama T. Successful treatment of tracheal stenosis due to a broken uncovered metallic stent placed over 20 years ago in a patient with recurrent polychondritis using argon plasma coagulation and airway ballooning. Respirol Case Rep 2024; 12:e70034. [PMID: 39319333 PMCID: PMC11421887 DOI: 10.1002/rcr2.70034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 09/17/2024] [Indexed: 09/26/2024] Open
Abstract
A woman in her mid-60s with recurrent polychondritis was admitted to our hospital due to airway stenosis secondary to an uncovered metallic stent. She underwent a bronchoscopic intervention under general anaesthesia. During the procedure, the stent fracture was cauterized using Argon Plasma Coagulation (APC) cauterisation, performed with argon flow at 1 L/min and power set at 70 W. APC cauterisation caused the stent wire to flex circularly, gradually improving the stenosis. Tracheal dilatation was then performed using an airway balloon. Following the ballooning, a thin bronchoscope was easily passed through the lower trachea, and the left and right main bronchi were observed; therefore, the procedure was completed without any complications. APC coagulation and airway ballooning are viable choices for the temporary treatment of airway stenosis due to broken metallic stents.
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Affiliation(s)
- Yuki Takigawa
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Ken Sato
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Kenichiro Kudo
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Takeru Ichikawa
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Yuto Sasano
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | | | - Tomoyoshi Inoue
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Miho Fujiwara
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Suzuka Matsuoka
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Hiromi Watanabe
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Akiko Sato
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Keiichi Fujiwara
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
| | - Takuo Shibayama
- Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
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Figaro NJ, Figaro KA, Juman JS, Arozarena R, Davis King K, Juman S. Pediatric-Onset Relapsing Polychondritis With Otolaryngeal Manifestations. Cureus 2023; 15:e40085. [PMID: 37425495 PMCID: PMC10327613 DOI: 10.7759/cureus.40085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Relapsing polychondritis (RP) is a rare autoimmune disease that can present with various clinical manifestations. Among the affected sites, the ear, nose, and throat cartilages are frequently involved, often leading to subtle and episodic symptoms that can be challenging to diagnose. A high index of suspicion is necessary for the early identification of these subtle signs, which can aid in early diagnosis and prompt management. In this report, we present a rare case of pediatric-onset relapsing polychondritis that was initially misdiagnosed as laryngotracheobronchitis.
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Affiliation(s)
- Nicholas J Figaro
- Otolaryngology-Head and Neck Surgery, Eric Williams Medical Sciences Complex, Champ Fleurs, TTO
| | - Keegan A Figaro
- Medicine, Eric Williams Medical Sciences Complex, Champ Fleurs, TTO
| | - Jibran S Juman
- Otolaryngology-Head and Neck Surgery, Eric Williams Medical Sciences Complex, Champ Fleurs, TTO
| | - Rodolfo Arozarena
- Otolaryngology-Head and Neck Surgery, The University of the West Indies, Saint Augustine, TTO
| | - Keisha Davis King
- Rheumatology, Eric Williams Medical Sciences Complex, Champ Fleurs, TTO
| | - Solaiman Juman
- Otolaryngology-Head and Neck Surgery, The University of the West Indies, Saint Augustine, TTO
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3
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Handa H, Ooka S, Shimizu J, Suzuki N, Mineshita M. Evaluation of airway involvement and treatment in patients with relapsing polychondritis. Sci Rep 2023; 13:8307. [PMID: 37221366 DOI: 10.1038/s41598-023-35616-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/21/2023] [Indexed: 05/25/2023] Open
Abstract
Airway involvement in relapsing polychondritis (RP) can be debilitating and life threatening, often requiring interventional procedures. If standard therapies including systemic corticosteroid and immunosuppressive agents are ineffective, airway stenting is often required. Recently, biologics have been reported to be effective for RP, and the early administration of biologics may avoid airway stenting. To evaluate survival rates and treatment approaches, medical records of RP patients with airway involvement were reviewed. These cases were divided into the following groups: with and without malacia, stenting and non-stenting, and with and without biologics. Kaplan-Meier was used to calculate survival rates and log rank tests were used to analyze biologics groups. A total of 77 patients were enrolled. Airway stenting was performed in 13 patients, all of which developed airway malacia. The stenting group had significantly lower survival rates than the non-stenting group (p < 0.001). Stent-related complications were granulation tissue (85%) and mucostasis (69%). In the non-stenting group, a lower mortality rate was observed. A significantly higher survival rate was seen in patients administered biologics than without (p = 0.014). The early administration of biologics shows promise in preventing severe airway disorders that require airway stenting.
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Affiliation(s)
- Hiroshi Handa
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan.
| | - Seido Ooka
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
| | - Jun Shimizu
- Department of Immunology and Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Noboru Suzuki
- Department of Immunology and Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masamichi Mineshita
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
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Sangle SR, Hughes CD, Barry L, Qureshi S, Cheah CK, Poh YJ, D'Cruz DP. Relapsing polychondritis - A single Centre study in the United Kingdom. Autoimmun Rev 2023; 22:103352. [PMID: 37146927 DOI: 10.1016/j.autrev.2023.103352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES Relapsing Polychondritis (RP) is a rare immune mediated inflammatory disorder that may result in damage and destruction of cartilaginous tissues. PATIENTS AND METHODS We retrospectively analysed patients with a clinical diagnosis of RP. Patients were investigated using pulmonary function tests, dynamic high-resolution CT scans, bronchoscopy, laryngoscopy and/or PET-CT scans along with autoimmune serology. Patients had other specialist reviews when indicated. RESULTS We identified 68 patients with a diagnosis of RP, 55 (81%) were Caucasian, 8 (12%) Afro Caribbean, 4 (6%) Asian and 1 patient had Mixed Ethnicity. Twenty-nine (43%) had pulmonary involvement and in 16, pulmonary involvement was the initial presentation. The mean age at onset was 44 years (range 17-74). There was a mean diagnostic delay of 55 weeks. 66 (97%) patients received a combination of oral Prednisolone and disease modifying anti-rheumatic drugs. Twelve of 19 (63%) received biologics, with an initial good response, and 10 remain on treatment. 11 patients with respiratory collapse required CPAP to maintain airway patency. Twelve (18%) patients died due to RP and 9 had respiratory complications. Two patients developed myelodysplasia and one had lung carcinoma. In a multivariate regression analysis, the prognostic variables were ethnicity, nasal chondritis, laryngotracheal stricture and elevated serum creatinine. CONCLUSION RP is a rare autoimmune condition often associated with significant delays in diagnosis and initiation of treatment. Pulmonary involvement in RP may cause significant morbidity and mortality due to organ damage. Disease modifying anti rheumatic drugs and biologics should be considered early in the disease course to minimise adverse effects of long-term corticosteroid therapy and organ damage.
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Affiliation(s)
- Shirish R Sangle
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - Catherine D Hughes
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - Lucinda Barry
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - Sumera Qureshi
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - Chee Ken Cheah
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - Yih Jia Poh
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK
| | - David P D'Cruz
- The Louise Coote Lupus Unit, 4th Floor, Tower Wing, Guy's Hospital, Guy's and St Thomas' and King's College Medical School, London SE1 9RT, UK. david.d'
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Yanagihara T, Ohgushi M, Setoguchi T, Ogo N, Inutsuka Y, Fujiwara H, Asoh T, Sunami S, Yoneda R, Maeyama T. Early Recognition and Treatment of Relapsing Polychondritis. Cureus 2022; 14:e21463. [PMID: 35223247 PMCID: PMC8862614 DOI: 10.7759/cureus.21463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/08/2022] Open
Abstract
We describe the case of a 60-year-old Japanese man with relapsing polychondritis (RP). The patient was referred to Hamanomachi Hospital due to mild elevation of C-reactive protein and mild anemia on medical checkup without any symptoms. Body CT imaging showed thickened tracheal and bronchial walls with no active lesions in the lung. Precise physical examination revealed swelling in both ears. Bronchoscopy revealed redness and swelling of the tracheal and bronchial mucosa in the membranous lesion. Histologic examination of the bronchial biopsy showed inflammatory cell infiltration in the sub-mucosa with no vasculitis. Serum anti-type 2 collagen antibodies were found to be positive (33.9 EU/mL). Corticosteroid treatment improved his tracheochondritis. It is challenging to diagnose RP in the early stage due to its rarity and nonspecific symptoms. Airway involvement in RP is irreversible and the major cause of morbidity and mortality; hence, early recognition of airway involvement and treatment is warranted.
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Zhou P, Fu B, Zhang C, Chen K, Xia Q, Tang W, Yu W, Huang W. Bronchoscopy-Guided Intervention Therapy With Extracorporeal Membrane Oxygenation Support for Relapsing Polychondritis With Severe Tracheobronchomalacia: A Case Report and Literature Review. Front Med (Lausanne) 2021; 8:695505. [PMID: 34888317 PMCID: PMC8649689 DOI: 10.3389/fmed.2021.695505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022] Open
Abstract
Relapsing polychondritis is an immune disorder of unknown etiology involving multiple systems that is characterized by persistent inflammation and destruction of cartilage, including the ears, nose, costal, joint, and airways. Airway involvement caused by relapsing polychondritis is common, and tracheobronchomalacia is the most serious complication, which is life-threatening. Currently, the exact mechanism of relapsing polychondritis with tracheobronchomalacia is unknown. Although glucocorticoids and immunosuppressive agents are administered, failures often occur. Currently, bronchoscopy-guided intervention therapy used in tracheobronchomalacia caused by chronic obstructive pulmonary disease or other etiology has gradually increased, but bronchoscopy-guided intervention therapy with extracorporeal membrane oxygenation assist used in tracheobronchomalacia caused by relapsing polychondritis has not been reported. Here, we report a case of relapsing polychondritis with severe tracheobronchomalacia. Although drug therapy was provided and airway stent implantation was performed, the tracheal stenosis was further aggravated. Because conventional anesthesia and mechanical ventilation cannot meet the needs of bronchoscopy-guided intervention therapy or guarantee sufficient safety. The intervention treatment was performed with the support of extracorporeal membrane oxygenation, which was successfully completed without obvious complications. The symptoms were significantly improved, and the patient was discharged uneventfully.
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Affiliation(s)
- Pengcheng Zhou
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bing Fu
- Department of Cardiothoracic Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chuantao Zhang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Keling Chen
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qianming Xia
- Department of Respiratory Medicine, The Aviation Industry Corporation of China (AVIC) 363 Hospital, Chengdu, China
| | - Wenjun Tang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Yu
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenhui Huang
- Department of Cardiothoracic Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Kothari T, Valsamakis T, Sridhar AV, Ahmed MI. Case of paediatric relapsing polychondritis with severe airway involvement: the challenges of long-term airway and respiratory management. BMJ Case Rep 2021; 14:e239774. [PMID: 34380670 PMCID: PMC8359488 DOI: 10.1136/bcr-2020-239774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/04/2022] Open
Abstract
We describe a case of a 15-year-old girl diagnosed with relapsing polychondritis (RP) with involvement of the tracheobronchial tree, resulting in an increased difficulty in breathing, hoarseness of voice and stridor.Her case required the input of multiple specialities including ear, nose and throat, rheumatology, respiratory team and intensive care. Airway assessment and imaging showed glottic and subglottic stenosis and left bronchomalacia. Despite the use of steroids, cyclophosphamide and rituximab, her symptoms progressed and she was started on overnight non-invasive ventilation.She had further relapses of her airway RP-she was started on adalimumab and methotrexate and underwent monthly balloon dilatations which helped with her symptoms and facilitated a safe discharge home. However, she had further relapses and intensive care admissions and following further discussions, a tracheostomy was inserted. She is now stable on her tracheostomy and is off any respiratory support.
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Wang S, Chi C, Xu D, Ye Y. Relapsing polychondritis: an unusual cause of sore throat, painful ear swelling and bilateral costal margin pain. BMJ Case Rep 2021; 14:14/2/e238646. [PMID: 33541982 PMCID: PMC7868281 DOI: 10.1136/bcr-2020-238646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 54-year-old Chinese woman presented with a 3-month history of sore throat and dry cough, which was treated as chronic pharyngitis with minimal improvement. One month ago, she presented with painful right ear swelling without signs or symptoms of otitis media or otitis externa. She was treated with antibiotics and antiviral drugs without any improvement. Two weeks prior to her presentation to hospital, she developed bilateral costal margin pain with raised C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), mild chronic pharyngitis and painful right ear swelling. All other investigations including bloods and imaging were non-specific. Her painful right auricle swelling prompted the diagnosis of relapsing polychondritis (RP), which was supported by clinical improvement with high-dose corticosteroids. RP is a clinical diagnosis with non-specific inflammation of affected cartilage. It is a diagnosis of exclusion and early diagnosis can be made by the most common presenting feature of auricular chondritis.
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Affiliation(s)
- Shuang Wang
- Rheumatology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Christopher Chi
- Curtin Medical School, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Dan Xu
- Curtin Medical School/School of Public Health, Faculty of Health Sciences, Curtin University Bentley Campus, Perth, Western Australia, Australia,Medical Education & General Practice, The First Affiliated Hospital, Sun Yan-Sen University, Guangzhou, China
| | - Yujin Ye
- Rheumatology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
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Kuba K, Nakahira M, Inoue H, Kogashiwa Y, Ebihara Y, Sugasawa M. Nivolumab-related tracheobronchial chondritis: Extremely rare manifestation of an immune-related adverse effect. Head Neck 2020; 42:E43-E48. [PMID: 32888225 DOI: 10.1002/hed.26456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/17/2020] [Accepted: 08/26/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Programmed death-1 checkpoint inhibitors, such as nivolumab, have successfully been utilized for recurrent or metastatic squamous cell carcinoma of the head and neck; however, their use may be associated with immune-related adverse effects (irAEs). METHODS We describe a case of tracheobronchial chondritis as a rare irAE in a 72-year-old man with multiple pulmonary metastases of hypopharyngeal squamous cell carcinoma treated with nivolumab, who was seen with a 2-week history of fever, nonproductive cough, and dyspnea. RESULTS CT revealed a thickened tracheobronchial wall and narrowed intraluminal space resulting in respiratory symptoms, despite significant clinical response of the metastases. He was clinically diagnosed with tracheobronchial chondritis and treated successfully by steroid therapy. His diagnosis was confirmed by a positive serum anti-collagen type 2 antibody test. CONCLUSIONS In addition to interstitial lung disease, tracheobronchial chondritis should be considered as a possible irAE in patients with acute respiratory symptoms after nivolumab administration.
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Affiliation(s)
- Kiyomi Kuba
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Mitsuhiko Nakahira
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hitoshi Inoue
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasunao Kogashiwa
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuhiro Ebihara
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masashi Sugasawa
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Saitama, Japan
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Danve A. Thoracic Manifestations of Ankylosing Spondylitis, Inflammatory Bowel Disease, and Relapsing Polychondritis. Clin Chest Med 2019; 40:599-608. [PMID: 31376894 DOI: 10.1016/j.ccm.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ankylosing spondylitis, inflammatory bowel disease (IBD), and relapsing polychondritis are immune-mediated inflammatory diseases with variable involvement of lungs, heart and the chest wall. Ankylosing spondylitis is associated with anterior chest wall pain, restrictive lung disease, obstructive sleep apnea, apical fibrosis, spontaneous pneumothorax, abnormalities of cardiac valves and conduction system, and aortitis. Patients with IBD can develop necrobiotic lung nodules that can be misdiagnosed as malignancy or infection. Relapsing polychondritis involves large airways in at least half of the patients. Relapsing polychondritis can mimic asthma in some patients. Medications used to treat these inflammatory conditions can cause pulmonary complications such as infections, pneumonitis, and rarely serositis.
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Affiliation(s)
- Abhijeet Danve
- Section of Rheumatology, Department of Medicine, Yale School of Medicine, 300 Cedar Street, TACS-525, New Haven, CT 06520-8031, USA.
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11
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Wu X, Zhang X, Zhang W, Huang H, Li Q. Long-Term Outcome of Metallic Stenting for Central Airway Involvement in Relapsing Polychondritis. Ann Thorac Surg 2019; 108:897-904. [PMID: 30910657 DOI: 10.1016/j.athoracsur.2019.02.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Placement of uncovered self-expandable metallic stents was found to successfully alleviate critical airflow limitation in patients with relapsing polychondritis (RP) with central airway involvement by several reports. However, the long-term outcome of airway metallic stenting in patients with RP remain unclear. METHODS We retrospectively analyzed patients with RP who underwent airway metallic stenting with the use of fiberoptic bronchoscopy between September 1, 2009, and October 1, 2017, in Shanghai. Outcome measurements, including modified Medical Research Council (mMRC) dyspnea score, 6-minute walk distance (6MWD), spirometry, and bronchoscopic findings, as well as adverse events after stent placement, were collected. RESULTS A total of 27 patients were included; the median patient age was 58 years (range: 41 to 74 years), and 19 were men (70.4%). Nineteen uncovered self-expandable metallic stents were placed in the trachea and 39 in the main bronchi. The median follow-up time was 50.5 months (range: 6 to 100 months). The baseline forced expiratory volume in 1 second (FEV1) percentage predicted (%pred), FEV1/forced vital capacity (FVC), and peak expiratory flow (PEF) was 24.2 ± 3.7, 27.2 ± 5.6, and 0.99 ± 0.21 L/min, respectively. One day after the procedure, improvement from baseline in FEV1 %pred, FEV1/FVC, and PEF was 17.9 ± 8.9 (p = 0.001), 19.8 ± 10.9 (p = 0.002), and 0.69 ± 0.44 L/min (p = 0.001), respectively. Changes in the following variables were also statistically and clinically significant: 6MWD of 193.7 ± 83.4 m; mMRC dyspnea score of -1.2 ± 0.4 points (both p < 0.05). The improvements were maintained at 5 years: a mean change in FEV1 %pred, FEV1/FVC, PEF, 6MWD, and mMRC score was 19.5 ± 6.7, 13.9 ± 5.0, 0.82 ± 0.40 L/min, 134.7 ± 66.2 m, and -0.83 ± 0.29 points, respectively. Cough, foreign body sensation, mucus production, and granulomas were common adverse events, occurring in 48.1% (13 of 27), 40.7% (11 of 27), 29.6% (8 of 27), and 25.9% (7 of 27) of the subjects. However, none of those complications were severe enough to require urgent bronchoscopic interventions. CONCLUSIONS Airway metallic stenting in patients with RP with central airway involvement resulted in long-term clinical benefits in lung function, exercise tolerance, and dyspnea with an acceptable safety profile.
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Affiliation(s)
- Xiaodong Wu
- Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xin Zhang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Wei Zhang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China
| | - Qiang Li
- Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China; Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, China.
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