| 英文摘要 |
A 41-year-old woman with relapsing polychondritis presented with fever, left auricular swelling, and tenderness for one month. These symptoms persisted despite of treatment with parenteral antibiotics. A magnetic resonance imaging of head and neck showed diffuse soft tissue swelling of left auricle with abnormal enhancement, compatible with perichondritis (Fig. A). Prednisolone, hydroxychloroquine and colchicine were prescribed by a rheumatologist, with gradual improvement of left auricular swelling. However, right auricular swelling occurred three months later, along with intermittent stridor. A bronchoscopy revealed significant bilateral main bronchus narrowing (Fig. B). Methylprednisolone mini-pulse therapy was administered. She did not return for follow-up thereafter. Six months later, she visited our emergency department again due to pneumonia with progressive stridor. Reportedly she developed several times of pneumonia during this period, which was managed in other hospital. A computed tomography of chest showed thickening of tracheal wall with calcification (Fig. C, arrow), as well as narrowing of trachea and bronchi in 3D reconstructive images (Fig. D, arrow). Elective tracheostomy was performed subsequently because of concerning the refractoriness of symptoms after pulse cyclophosphamide, methylprednisolone minipulse and azathioprine treatment. She was doing well now in our rheumatologic clinic with regular follow-up. |
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