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Ayyildiz V, Aydin Y, Ogul H. Unusual cause of the left main bronchus stenosis: relapsing polychondritis. Indian J Thorac Cardiovasc Surg 2024; 40:500-501. [PMID: 38919186 PMCID: PMC11194239 DOI: 10.1007/s12055-024-01707-8] [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: 01/20/2024] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 06/27/2024] Open
Abstract
Relapsing polychondritis is a rare disease that causes inflammation and destruction of cartilage and connective tissue. It can be associated with other autoimmune rheumatologic and hematologic diseases. Herein, we report a 38-year-old male patient with relapsing polychondritis and diffuse stenosis of the left main bronchus.
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Affiliation(s)
- Veysel Ayyildiz
- Department of Radiology, Kocaeli City Hospital, Izmit, Kocaeli, Turkey
| | - Yener Aydin
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, 25240 Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Medical Faculty, Duzce University, Duzce, Turkey
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Winter G, Löffelmann T, Chaya S, Kaiser H, Prenzler NK, Warnecke A, Wetzke M, Derlin T, Renz D, Stueber T, Länger F, Schütz K, Schwerk N. Relapsing Polychondritis with Tracheobronchial Involvement: A Detailed Description of Two Pediatric Cases and Review of the Literature. KLINISCHE PADIATRIE 2024; 236:97-105. [PMID: 38224687 PMCID: PMC10883755 DOI: 10.1055/a-2230-1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Relapsing polychondritis (RP) is a rare immune-mediated disease that primarily affects the cartilaginous structures of the ears, nose and airways. The clinical spectrum ranges from mild to severe disease characterized by progressive destruction of cartilage in the tracheobronchial tree leading to airway obstruction and acute respiratory failure. Early diagnosis is crucial to prevent irreversible airway damage and life-threatening complications. Due to its rarity and variability of symptoms, the diagnosis of RP is often delayed particularly in childhood. To address this and increase awareness of this rare disease, we present a detailed case report of two adolescent females affected by RP. We aim to describe the clinical findings, consequences of a delayed diagnosis and provide a review of the current literature.
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Affiliation(s)
- Greta Winter
- Department of Paediatric Pneumology, Allergy and Neonatology, Hannover
Medical School Centre for Paediatrics and Adolescent Medicine, Hannover,
Germany
| | - Tara Löffelmann
- Department of Paediatric Pneumology, Allergy and Neonatology, Hannover
Medical School Centre for Paediatrics and Adolescent Medicine, Hannover,
Germany
| | - Shaakira Chaya
- Division of Paediatric Pulmonology, Department of Paediatrics and Child
Health, University of Cape Town, Red Cross War Memorial Children’s
Hospital, Cape Town, South Africa
| | - Hannah Kaiser
- Department of Paediatric Pneumology, Allergy and Neonatology, Hannover
Medical School Centre for Paediatrics and Adolescent Medicine, Hannover,
Germany
| | - Nils Kristian Prenzler
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover
Medical School, Hannover, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover
Medical School, Hannover, Germany
| | - Martin Wetzke
- Department of Paediatric Pneumology, Allergy and Neonatology, Hannover
Medical School Centre for Paediatrics and Adolescent Medicine, Hannover,
Germany
- German Centre for Lung Research (DZL), Hannover Medical School,
Hannover, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover,
Germany
| | - Diane Renz
- Institute of Diagnostic and Interventional Radiology, Department of
Paediatric Radiology, Hannover Medical School, Hannover, Germany
| | - Thomas Stueber
- Department of Anaesthesiology and Intensive Care Medicine, Hannover
Medical School, Hannover, Germany
| | - Florian Länger
- German Centre for Lung Research (DZL), Hannover Medical School,
Hannover, Germany
- Institute of Pathology, Hannover Medical School, Hannover,
Germany
| | - Katharina Schütz
- Department of Paediatric Pneumology, Allergy and Neonatology, Hannover
Medical School Centre for Paediatrics and Adolescent Medicine, Hannover,
Germany
| | - Nicolaus Schwerk
- German Centre for Lung Research (DZL), Hannover Medical School,
Hannover, Germany
- Pediatric Pulmonology and Neonatology, Hannover Medical School Centre
for Paediatrics and Adolescent Medicine, Hannover, Germany
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Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010065. [PMID: 36676688 PMCID: PMC9862252 DOI: 10.3390/medicina59010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022]
Abstract
Relapsing polychondritis (RP) is a rare autoimmune disorder that causes inflammation and deterioration of cartilaginous structures such as the ears, nose, joints and laryngotracheobronchial tree. A 42-year-old man receiving treatment for RP underwent open reduction and internal fixation of a femur fracture under spinal anesthesia and with sedation by propofol and remifentanil. The level of sedation was monitored via a bispectral index (BIS), and maintained at between 60 and 80. At the end of the operation, he lost consciousness and displayed weak respiratory effort. During mask ventilation, the patient was judged to have respiratory failure due to high end-tidal CO2 (EtCO2) concentration and respiratory acidosis in an arterial-blood-gas analysis (ABGA). Ventilation through a properly inserted laryngeal-mask-airway or endotracheal intubation were impossible; instead, a surgical tracheotomy was performed. After recovering from respiratory failure with ventilatory support in the intensive care unit (ICU), he experienced the same symptoms three more times, requiring ventilatory support. He was discharged with bilevel positive-airway-pressure (BiPAP), after successful adaptation.
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Chen JY, Li XY, Zong C. Relapsing polychondritis with isolated tracheobronchial involvement complicated with Sjogren's syndrome: A case report. World J Clin Cases 2022; 10:6563-6570. [PMID: 35979285 PMCID: PMC9294918 DOI: 10.12998/wjcc.v10.i19.6563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Relapsing polychondritis (RP) is a rare, long-term, and potentially life-threatening disease characterised by recurrent paroxysmal inflammation that can involve and destroy the cartilage of the external ear, nose, larynx, and trachea.
CASE SUMMARY We here report a case of RP involving solely the tracheobronchial cartilage ring (and not the auricular. nasal or articular cartilage) complicated by Sjögren's syndrome in a 47-year-old female whose delayed diagnosis caused a sharp decline in pulmonary function. After corticosteroid treatment, her pulmonary function improved.
CONCLUSION In such cases, our experience suggested that 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and fiberoptic bronchoscopy should be used to diagnose airway chondritis as relapsing polychondritis in the early phase of disease.
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Affiliation(s)
- Jun-Yan Chen
- Department of Pulmonary and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
| | - Xiao-Yan Li
- Department of Pulmonary and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
| | - Chen Zong
- Department of Pulmonary and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
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