2023 年 1 巻 2 号 p. 123-127
An 82-year-old woman with severe bilateral sensorineural hearing loss visited our hematology department for the management of essential thrombocythemia. Approximately 5 months before her presentation, she developed dyspnea on exertion and underwent cardiac catheterization for suspected heart failure; however, no cause was identified. Approximately 4 months later, she was referred to the respiratory department with a persistent cough. Bronchial asthma was suspected, and pulmonary function tests were performed. In the meantime, inhaled steroid therapy was prescribed. Two days later, her dyspnea worsened, and she was rushed to our hospital, where she was found to have wheezing and hypoxemia. However, her cardiac function was preserved. Contrast-enhanced computed tomography of the chest revealed a mass protruding into the trachea, resulting in intratracheal stenosis. Two biopsies were obtained from this area in two separate bronchoscopies while the patient was intubated to secure her airway. Pathological examination of the biopsies revealed only inflammatory granulation tissue. Steroid medication was continued to prevent laryngeal edema, and the elevated intratracheal lesion resolved. Given the presence of bilateral sensorineural hearing loss probably caused by cochlear dysfunction, suspected respiratory chondritis, and favorable response to corticosteroid administration, our final diagnosis was relapsing polychondritis.
