Chronological assessment of airway lesions in relapsing polychondritis by positron emission tomography

Intern Med. 2015;54(9):1099-102. doi: 10.2169/internalmedicine.54.3775. Epub 2015 May 1.

Abstract

A 40-year old woman presented with pyrexia, productive cough, and bilateral precordial pain. Positron emission tomography (PET)-computed tomography (CT) showed high, diffuse F-18 deoxyglucose accumulation in the tracheal, peribronchial, and bilateral costal cartilage. We diagnosed her with relapsing polychondritis (RP) based on McAdam's criteria. Airway lesions are a major prognostic indicator of RP, and so chronological assessment and control is essential. In this patient, PET-CT accurately reflected both the location and severity of the inflammation and helped to guide treatment decision-making and facilitated early detection of recurrence. However, its high cost is prohibitive to frequent use, making it necessary to comprehensively evaluate serum C-reactive protein levels, bronchoscopy, spirometry, and 3D-CT.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchoscopy
  • Chest Pain / etiology
  • Costal Cartilage / diagnostic imaging
  • Costal Cartilage / metabolism
  • Cyclosporine / administration & dosage*
  • Early Diagnosis
  • Female
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Methotrexate / administration & dosage*
  • Multimodal Imaging / methods
  • Polychondritis, Relapsing / diagnostic imaging*
  • Polychondritis, Relapsing / drug therapy
  • Polychondritis, Relapsing / metabolism*
  • Positron-Emission Tomography* / methods
  • Prognosis
  • Radiopharmaceuticals / metabolism
  • Recurrence
  • Tomography, X-Ray Computed
  • Trachea / diagnostic imaging
  • Trachea / metabolism

Substances

  • Immunosuppressive Agents
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Cyclosporine
  • Methotrexate