A Case of Relapsing Polychondritis with Respiratory Tract Involvement in Which FDG-PET/CT Was of Great Value for Diagnosis and Management

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  • FDG-PET/CTが診断治療に有用であった気道病変先行型再発性多発性軟骨炎(RP)の1例

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Background. Relapsing polychondritis (RP) is a comparatively rare disease that has lesions in the cartilage throughout the body. Diagnosis in the early stages of RP is difficult, especially in cases which initially involve the respiratory tract, and result in irreversible damage. Case. The case was a 61-year-old man, whose chief complaint was nonproductive cough. Initially asthma and/or upper airway infections were suspected, but neither inhalation corticosteroids nor antibiotics were effective. FDG-PET was performed and accumulation of FDG was observed in the tracheal cartilage. Bronchoscopy showed flare and swelling of the tracheal cartilage, and changes and narrowing in the left main bronchus. Because of the steroid response and ophthalmic lesions, we diagnosed it as RP. After starting treatment with prednisolone, the symptoms disappeared, and manifestations on FDG-PET/CT and bronchoscopy were normalized. Conclusion. The diagnosis was difficult although the respiratory tract involvement was important in this disease and significantly affected prognosis. FDG-PET/CT was useful for early diagnosis and management in this case.

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