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Chest Imaging and Pathology for Clinicians |

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 Cough66-Year-Old Man With Nodular Airway Lesions

Carlos D. Martínez-Balzano, MD; Andres Sosa, MD; Sean O’Reilly, MD; Yuna Gong, MD; Richard Irwin, MD, Master FCCP
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From the Division of Lung, Allergy, and Critical Care Medicine (Drs Martínez-Balzano, Sosa, O’Reilly, and Irwin) and the Department of Pathology (Dr Gong), University of Massachusetts Medical School, Worcester, MA.

CORRESPONDENCE TO: Carlos D. Martínez-Balzano, MD, Division of Lung, Allergy, and Critical Care Medicine, Department of Medicine, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA 01655; e-mail: Carlos.Martinez-Balzano@umassmemorial.org


This case was accepted in abstract form for a poster presentation at CHEST 2015, October 24-28, 2015, Montréal, QC, Canada.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(5):e142-e147. doi:10.1378/chest.15-0498
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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.

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