Relapsing polychondritis presented as inner ear involvement
Relapsing polychondritis presented as inner ear involvement
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复发性多软骨炎表现为内耳受累
DOI：
10.1017/s002221510013302x
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Y. Mizukami
中科院分区：
文献类型：
--
作者：
Y. Kimura;H. Miwa;M. Furukawa;Y. Mizukami
摘要 我们报告了一例罕见的复发性多软骨炎病例，其首发症状为内耳受累。这位53岁的日本男子出现了听力困难、双耳耳鸣、突发头晕等症状，但当时并没有耳廓软骨炎，这是复发性多软骨炎中最常见的表现。因此很难做出正确的诊断。每天口服泼尼松龙 15 毫克的类固醇治疗有效。在我们开始类固醇治疗近两个月后，患者抱怨对工作失去了兴趣，并报告在电视屏幕上出现幻觉，因此泼尼松龙的剂量减少至 10 毫克。随后幻觉消失，但血清C反应蛋白水平大幅升高。为了减少泼尼松龙的剂量，我们尝试了小剂量口服甲氨蝶呤。然而，当患者出现严重呕吐和腹泻时，我们不得不停止治疗。作为辅助治疗，我们使用了副作用很少的中草药“Sho-saiko-to”。随后症状和实验室异常明显改善。
Abstract We report a rare case of relapsing polychondritis with an initial symptom of inner ear involvement. This 53-year-old Japanese man experienced a hearing difficulty, tinnitus in both ears, and dizziness of sudden onset, but lacked auricular chondritis at that time, which is the most frequent finding in relapsing polychondritis. Thus it was difficult to reach a correct diagnosis. Steroid therapy, with oral prednisolone 15 mg daily, was effective. Almost two months after we began the steroid therapy, the patient complained of losing interest in his work and reported a hallucination vision on the TV screen, so the dose of prednisolone was decreased to 10 mg. The hallucinations then disappeared, but the serum level of C-reactive protein increased highly. To reduce the dose of prednisolone, we tried low-dose oral methotrexate. However, we had to discontinue it when the patient experienced severe vomiting and diarrhoea. As adjuvant therapy, we then administered Sho-saiko-to, Chinese herbal medicines with few side effects. Symptoms and laboratory abnormalities then improved markedly.