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Images in Clinical Rheumatology
Diagnosis of Relapsing Polychondritis in a Patient With Chronic Cough and Without Nasal or Auricular Chondritis
Diagnóstico de policondritis recidivante en una paciente con tos crónica y sin condritis nasal ni auricular
Luis Gorospe Sarasúaa,
Corresponding author
luisgorospe@yahoo.com

Corresponding author.
, Deisy Barrios-Barretob, Ismael Said-Criadoc, Carlos de la Puente-Bujidosd
a Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain
b Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain
c Servicio de Medicina Interna, Hospital La Milagrosa, Madrid, Spain
d Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
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        "titulo" => "Diagn&#243;stico de policondritis recidivante en una paciente con tos cr&#243;nica y sin condritis nasal ni auricular"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; CT axial view where a noticeable thickening of the tracheal walls &#40;arrows&#41; may be observed&#44; together with highly significant reduction in their lumens&#46; &#40;B&#41; CT axial view &#40;lung imaging window&#41; where major circumferential thickening of the walls of both main bronchi may also be observed&#44; together with serious reduction in their lumen quality &#40;arrows&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 68-year-old patient&#44; a non smoker&#44; who sought medical attention due to a dry cough of several months onset&#46; During the previous few weeks the patient had presented with intermittent&#44; low-grade fever in the evenings&#46; The patient&#39;s medical background only highlighted several episodes of anterior uveitis which responded to topical treatment with glucocorticoids&#46; A chest X-ray did not show any radiologic changes&#44; but computerised tomography &#40;CT&#41; of the chest revealed a noticeable circumferential thickening of the walls of the trachea &#40;respecting the posterior tracheal wall&#41; and the main bronchi which had led to a major reduction in their lumens &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Subsequent to these findings&#44; a diagnosis of relapsing polychondritis &#40;RP&#41; was made&#44; which was confirmed with transbronchial biopsy performed by fibrobronscopy&#46; The latter revealed inflammatory changes to the pericartilaginous structures&#44; thus meeting the Damiani and Levine criteria for the diagnosis of RP&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Respiratory function tests only showed a slight airflow obstruction&#46; Other rheumatic&#44; endocrine and haematological diseases which may be associated with RP in up to 33&#37; of cases&#44; were ruled out&#46; The patient responded favourably to treatment with glucocorticoids and azathioprine&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">RP is a rare multisystemic disease characterised by recurrent and progressive episodes of inflammation and the destruction of cartilaginous tissue affecting&#44; among other organs&#44; the outer ear&#44; nose and airways&#46; For most patients with RP initial clinical symptoms are usually nasal and&#47;auricular chondritis&#46; Both ocular involvement &#40;in the form of uveitis&#44; scleritis or keratitis&#41; and the involvement of tracheobronchial cartilage are highly uncommon forms of RP presentation&#44; and they remind us that initial atypical manifestations of this disease exist and require differential diagnosis to apparently banal symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical liabilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocol of their centre of work on the publication of patient data&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Gorospe Saras&#250;a L&#44; Barrios-Barreto D&#44; Said-Criado I&#44; de la Puente-Bujidos C&#46; Diagn&#243;stico de policondritis recidivante en una paciente con tos cr&#243;nica y sin condritis nasal ni auricular&#46; Reumatol Clin&#46; 2019&#59;15&#58;e51&#8211;e52&#46;</p>"
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Article information
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Original language: English
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Idiomas
Reumatología Clínica (English Edition)
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