Successful treatment with noninvasive positive-pressure ventilation based on the prediction of disease onset using CT and respiratory function tests in an elderly patient with relapsing polychondritis

Intern Med. 2013;52(10):1085-9. doi: 10.2169/internalmedicine.52.9035. Epub 2013 May 15.

Abstract

An 83-year-old man who had been receiving treatment for bronchial asthma since 62 years of age experienced difficulty breathing on exertion and was admitted to the hospital. On admission, computed tomography revealed tracheal wall thickening, while test results for antinuclear antibodies and anti-type II collagen antibodies were positive. Since a saddle nose deformity, malacia of the auricles and sensorineural deafness were also observed, relapsing polychondritis was diagnosed. Measuring the peak expiratory flow rate was useful in the early airway assessment. During the follow-up period, the patient's dyspnea worsened and noninvasive positive-pressure ventilation was introduced. As a result, the subjective symptoms improved.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Airway Obstruction / etiology
  • Airway Obstruction / physiopathology
  • Airway Obstruction / therapy*
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Antinuclear / blood
  • Asthma / complications
  • Asthma / drug therapy
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Bronchial Diseases / diagnostic imaging
  • Bronchial Diseases / etiology
  • Bronchial Diseases / therapy
  • Collagen Type II / immunology
  • Dyspnea / etiology
  • Dyspnea / therapy
  • Forced Expiratory Volume*
  • Humans
  • Male
  • Nose Deformities, Acquired / etiology
  • Polychondritis, Relapsing / complications*
  • Polychondritis, Relapsing / diagnosis
  • Polychondritis, Relapsing / immunology
  • Positive-Pressure Respiration*
  • Tomography, X-Ray Computed*
  • Tracheal Diseases / diagnostic imaging
  • Tracheal Diseases / etiology
  • Tracheal Diseases / therapy
  • Vital Capacity*

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Antinuclear
  • Autoantibodies
  • Collagen Type II