A Retrospective Analysis of 60 Relapsing Polychondritis Patients with
Laryngo-tracheobronchial Involvement
Abstract
Objectives High incidence of laryngo-tracheobronchial symptoms was
reported in Chinese patients with relapsing polychondritis (RP),but it
is either misdiagnosed or delayed in diagnosis during the early stage.
Characteristics of RP patients with laryngo-tracheobronchial involvement
were summarized in this study to increase awareness of this disease.
Design, Setting and Participants Sixty RP patients with
laryngo-tracheobronchial involvement hospitalized in Beijing Tongren
Hospital were analyzed retrospectively. Results A total of 31 males and
29 females were included in the study with an average age of 37.3+16.7
years. The median delay between onset and diagnosis was 12.5 months
(range, 1 to 156 months). The rate of misdiagnosis was as high as 60%.
The most common initial respiratory symptom was hoarseness (23/60,
38.3%), followed by dyspnea (11/60, 18.3%) and cough (9/60, 15.0%).
The most common accumulated respiratory symptom was dyspnea (53/60,
88.3%), followed by hoarseness (52/60, 86.7%) and cough (35/60,
58.3%). Subglottic stenosis was observed in 51 cases (85.0%).
Congested, swollen vocal cords and arypiglottic folds, which looked like
acute laryngitis, were observed in 41 cases (68.3%) and 30 cases
(50.0%) respectively. Cricoid cartilage was the most easily involved
laryngeal cartilage on CT (39/60, 65.0%). Conclusions In RP patients
with laryngotracheobronchial involvement, cricoid cartilage is the most
easily involved airway cartilage. In cases of recurrent laryngitis and
subglottic stenosis without clear cause, RP should be a candidate
diagnosis. Key words Polychondritis, Relapsing; Larynx; Trachea;
Bronchi; Cartilage