Sudden Respiratory Failure due to Tracheobronchomalacia by Relapsing Polychondritis, Successfully Rescued by Multiple Metallic Stenting and Tracheostomy

Daisuke Oryoji; Nobuyuki Ono; Daisuke Himeji; Kyoko Yoshihiro; Yasufumi Kai; Motohiro Matsuda; Hiroshi Tsukamoto; Akira Ueda

doi:10.2169/internalmedicine.8778-16

CASE REPORTS

Sudden Respiratory Failure due to Tracheobronchomalacia by Relapsing Polychondritis, Successfully Rescued by Multiple Metallic Stenting and Tracheostomy

Daisuke Oryoji, Nobuyuki Ono, Daisuke Himeji, Kyoko Yoshihiro, Yasufumi Kai, Motohiro Matsuda, Hiroshi Tsukamoto, Akira Ueda

Author information

Daisuke Oryoji
Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Japan
Nobuyuki Ono
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
Daisuke Himeji
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
Kyoko Yoshihiro
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
Yasufumi Kai
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
Motohiro Matsuda
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
Hiroshi Tsukamoto
Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Japan
Akira Ueda
Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan

Keywords: metallic stent, relapsing polychondritis, tracheobronchial stenosis, tracheobronchomalacia

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 24 Pages 3369-3372

DOI https://doi.org/10.2169/internalmedicine.8778-16

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Abstract

Relapsing polychondritis (RP) is a rare systemic autoimmune disease that affects cartilaginous structures. RP causes tracheobronchomalacia (TBM) by affecting the bronchial cartilage. TBM is a fatal condition characterized by excessive weakening of the walls of the trachea and bronchi. We herein report a case of a 73-year-old man who experienced sudden respiratory failure due to TBM caused by RP. Immunosuppressive treatment did not improve his respiratory failure. Multiple metallic stentings dramatically improved his severe airway symptoms. When the airway condition becomes lethal in RP patients, then metallic stenting can be a useful treatment option.

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