Positron emission tomography aids diagnosis of relapsing polychondritis

A 39-year-old man presented to the hospital in April 2011 with a 2-month history of tonsillitis, night sweats, fatigue, weight loss, shortness of breath on exertion and a dry cough. He was a non-smoker, previously fit and well with no regular medication. Examination of the respiratory, cardiovascula...

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Bibliographic Details
Published inBMJ case reports Vol. 2014; p. bcr2013203367
Main Authors Mahida, Rahul Y, Bowman, Simon, Naidu, Babu, Thickett, David R
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 05.03.2014
BMJ Publishing Group
SeriesCase Report
Subjects
Adult
Airway management
Biopsy
Family medical history
Fluorodeoxyglucose F18
Humans
Immunotherapy
Inflammation
Lymphatic system
Lymphoma
Male
Medical prognosis
Ostomy
Polychondritis, Relapsing - diagnostic imaging
Positron-Emission Tomography
Proteins
Radiopharmaceuticals
Rare Disease
Sarcoidosis
Thorax
Tuberculosis
United Kingdom
Urine
White
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Summary:A 39-year-old man presented to the hospital in April 2011 with a 2-month history of tonsillitis, night sweats, fatigue, weight loss, shortness of breath on exertion and a dry cough. He was a non-smoker, previously fit and well with no regular medication. Examination of the respiratory, cardiovascular and gastrointestinal systems was normal; he appeared generally well. C reactive protein and erythrocyte sedimentation rate were raised. A CT of the thorax showed mediastinal thickening and mediastinal lymphadenopathy. Whole body 18F-fluorodeoxyglucose positron emission tomography showed diffuse tracheobronchial activity. Tracheal and lymph node biopsies showed non-specific features. Lung function tests showed an obstructive picture. A diagnosis of relapsing polychondritis was made. Immunosuppressive treatment was started, initially with oral methotrexate and prednisolone, later progressing to intravenous methylprednisolone and intravenous cyclophosphamide. Repeat bronchoscopy showed improvement in inflammation; however, the patient's symptoms were not improved. The patient's symptoms and lung function currently remain stable on maintenance oral prednisolone.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ObjectType-Report-1
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ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-203367