A 66-Year-Old Man With a Past History of Relapsing Polychondritis Presented With Right Upper Lobe Consolidation, Nodular Airway Lesions, and a Corticosteroid-Responsive Chronic Cough.

Abstract

A 66-year-old male nonsmoker from Arizona was referred to our practice for evaluation of chronic cough. He had a history of biopsy-proven relapsing polychondritis manifesting as right auricular and nasal pain and swelling 9 months prior to presentation. The onset of his cough coincided with the diagnosis of relapsing polychondritis, and he was prescribed prednisone 90 mg/d, which promptly relieved his rheumatologic and respiratory symptoms. A chest radiograph, obtained prior to the initiation of therapy, was normal. Any attempts at decreasing the dose of the glucocorticoid to < 30 mg/d resulted in recurrence of the cough but not of the auricular or nasal symptoms. A second chest radiograph done 6 months before presentation, while the patient was receiving prednisone 20 mg/d, was normal as well. In anticipation of our evaluation, he stopped all glucocorticoids for 7 days. He was not receiving any other medications, and he had no history of an atopic diathesis.

• Authors: Carlos D Martínez-Balzano, Andres Sosa, Sean O'Reilly, Yuna Gong, Richard Irwin
• Journal: Chest (Chest) Vol. 148 Issue 5 Pg. e142-e147 (Nov 2015) ISSN: 1931-3543 [Electronic] United States
• PMID: 26527441 (Publication Type: Case Reports, Journal Article)

Chemical References

• Glucocorticoids
• Prednisone

Topics

• Aged
• Biopsy
• Chronic Disease
• Cough (diagnosis, drug therapy, etiology)
• Diagnosis, Differential
• Glucocorticoids (therapeutic use)
• Humans
• Male
• Polychondritis, Relapsing (complications, diagnosis)
• Prednisone (therapeutic use)
• Pulmonary Eosinophilia (complications, diagnosis, drug therapy)
• Tomography, X-Ray Computed