18F-FDG PET/CT Imaging of Vasculitis Complicated With Relapsing Polychondritis

Kamada, Hiroki; Takanami, Kentaro; Toyama, Yoshitaka; Saito, Makina; Takase, Kei‐ichiro

doi:10.1097/rlu.0000000000003060

Cited by 3 publications

(3 citation statements)

References 8 publications

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Section: Discussionmentioning

confidence: 99%

“…Prior studies have shown that 18 F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET)/CT images exhibited the characteristic features of relapsing polychondritis. 19,20 Chen et al conducted a review of 28 relapsing polychondritis patients with airway involvement, all of whom underwent PET/CT examination. 21 Twenty-four PET/CT scans of the tracheal and bronchial trachea revealed augmented density, tube wall oedema, thickening and calcification, and limited stenosis.…”

Section: Discussionmentioning

confidence: 99%

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Clinical analysis of relapsing polychondritis with airway involvement

et al. 2022

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Objective To identify the clinical characteristics, treatment, and prognosis of relapsing polychondritis patients with airway involvement. Methods Twenty-eight patients with relapsing polychondritis, hospitalised in the First Hospital of Shanxi Medical University between April 2011 and April 2021, were retrospectively analysed. Results Fifty per cent of relapsing polychondritis patients with airway involvement had a lower risk of ear and ocular involvement. Relapsing polychondritis patients with airway involvement had a longer time-to-diagnosis (p < 0.001), a poorer outcome following glucocorticoid combined with immunosuppressant treatment (p = 0.004), and a higher recurrence rate than those without airway involvement (p = 0.004). The rates of positive findings on chest computed tomography and bronchoscopy in relapsing polychondritis patients with airway involvement were 88.9 per cent and 85.7 per cent, respectively. Laryngoscopy analysis showed that 66.7 per cent of relapsing polychondritis patients had varying degrees of mucosal lesions. Conclusion For relapsing polychondritis patients with airway involvement, drug treatment should be combined with local airway management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical analysis of relapsing polychondritis with airway involvement

et al. 2022

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“…At present, there is no diagnostic standard sensitive enough to reach 100%[ 13 ]. Imaging examinations, such as CT, positron emission tomography–CT, tracheobronchoscopy, electronic fiber nasolaryngoscopy, and lung function and pathology could be included as auxiliary diagnostic criteria to improve early diagnostic sensitivity[ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Relapsing polychondritis causing breathlessness: Two case reports

Zhai¹,

Zhang²,

Guo³

et al. 2022

WJCC

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BACKGROUND Relapsing polychondritis is a rare multisystem autoimmune disease that mainly involves systemic cartilage and proteoglycan-rich tissues. If the larynx and trachea are involved, the patient’s condition deteriorates rapidly. When relapsing polychondritis becomes more advanced, the airways collapse and treatment is difficult, rendering a poor prognosis. Therefore, the diagnosis method, treatment strategy and prognosis of relapsing polychondritis with larynx and trachea involvement need to be elucidated to improve clinicians’ awareness of the disease. CASE SUMMARY A man and a woman were admitted because of breathlessness. Relapsing polychondritis was diagnosed after a series of accessory examinations. They were both treated with glucocorticoids and immunosuppressants, and underwent tracheotomy as their breathing difficulties could not be relieved by the medication. CONCLUSION The two cases highlight the importance of the timely diagnosis, full evaluation and initiating individualized treatment of relapsing polychondritis with larynx and trachea involvement. Laryngoscopy, bronchoscopy and pathological examination are helpful in diagnosis of this disease.

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¹⁸F‐FAPI versus ¹⁸F‐FDG PET/CT in the Diagnosis of Relapsing Polychondritis

Guo,

Chen,

Zhao

et al. 2024

Clinical Case Reports

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Relapsing polychondritis (RP) is a rare immune‐mediated systemic inflammatory disease with diverse clinical manifestations. Independent involvement of the respiratory system in RP is uncommon. In the event of respiratory involvement as the initial airway‐only manifestation, the diagnosis of RP is challenging and might be delayed, and patients with respiratory involvement exhibit a poor prognosis. However, no specific diagnostic method is currently available for RP with respiratory system involvement as the main clinical manifestation. We present a 49‐year‐old female with the complaint of chronic dry cough accompanied by shortness of breath after exercise that has persisted for over a year. The patient was treated using corticosteroids. The patient's symptoms improved rapidly with the administration of 5 days of methylprednisolone sodium succinate at a dose of 40 mg/day. The treatment was then switched to methylprednisolone tablets at a dose of 40 mg/day, and the dosage was reduced by 4 mg every week until the cessation of therapy. Meanwhile, oral cyclophosphamide tablets were administered once every day at a dose of 100 mg each time. After 1 month of treatment, the symptoms of cough disappeared, the modified british medical research council (mMRC) grade dropped from 4 to 2, and the COPD assessment test (CAT) score dropped from 30 to 17. Repeated CT of the chest revealed that the tracheal wall thickening had alleviated. No recurrence was revealed in the follow‐up visit 12 months after drug withdrawal. The patient underwent 18F‐FDG PET/CT examination before hormone and immunosuppressive therapy, and 18F‐FAPI PET/CT examination was performed 5 days later. The 18F‐FDG PET/CT method revealed slight thickening of the local wall of the trachea and the left and right main bronchus, with no increase in the FDG metabolism, and no abnormalities in the rest of the cartilage. 18F‐FAPI PET‐CT imaging showed increased FAPI uptake in various parts of the body, including trachea and bronchus. The present study reports that compared to 18F‐FDG PET/CT, the 18F‐FAPI PET/CT revealed more lesions and provided a better image contrast, suggesting the latter as a suitable diagnostic method for RP, which could assist in improving the clinical management of RP patients.

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18F-FDG PET/CT Imaging of Vasculitis Complicated With Relapsing Polychondritis

Cited by 3 publications

References 8 publications

Clinical analysis of relapsing polychondritis with airway involvement

Clinical analysis of relapsing polychondritis with airway involvement

Relapsing polychondritis causing breathlessness: Two case reports

¹⁸F‐FAPI versus ¹⁸F‐FDG PET/CT in the Diagnosis of Relapsing Polychondritis

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18F-FDG PET/CT Imaging of Vasculitis Complicated With Relapsing Polychondritis

Cited by 3 publications

References 8 publications

Clinical analysis of relapsing polychondritis with airway involvement

Clinical analysis of relapsing polychondritis with airway involvement

Relapsing polychondritis causing breathlessness: Two case reports

18F‐FAPI versus 18F‐FDG PET/CT in the Diagnosis of Relapsing Polychondritis

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¹⁸F‐FAPI versus ¹⁸F‐FDG PET/CT in the Diagnosis of Relapsing Polychondritis