Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T06:22:50.052Z Has data issue: false hasContentIssue false

Hoarseness as the initial manifestation of systemic lupus erythematosus

Published online by Cambridge University Press:  29 June 2007

Koichi Tsunoda*
Affiliation:
Department of Otolaryngology, Nissan Tamagawa Hospital, Tokyo.
Yasushi Soda
Affiliation:
Department of Otolaryngology, Hitachi General Hospital, Ibaragi, Japan.
*
Address for correspondence: Dr Koichi Tsunoda, M.D., Chief, Department of Otolaryngology, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, Japan. Fax: 81-3-3700-2090

Abstract

A 51-year-old woman complained of hoarseness of two years duration. The patient's past medical history was significant for autoimmunological hepatitis and arthritis for which she had not received treatment. Laryngoscopy and laryngeal stroboscopy revealed ‘bamboo joint-like nodules’ on both true vocal folds. These nodules resembled rheumatoid nodules and were suggestive of a collagen disease. Previous reports have documented that the treatment for such conditions related to collagen diseases is surgical resection. However, we initially attempted to treat the laryngeal lesions systemically with prednisolone. The hoarseness and the bamboo-like nodules disappeared six months after the treatment. Furthermore, the liver function test returned to normal and arthritis completely resolved. Based on our patient's response to this treatment, we diagnosed atypical-SLE and a lupus laryngitis. This case suggests that studies of the larynx may be helpful in the early diagnosis of collagan diseases and that such conditions may respond to systemic treatment.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Friedman, B. A., Rice, D. H. (1975) Rheumatoid nodules of the larynx. Archives of Otolaryngology 101: 361363.CrossRefGoogle ScholarPubMed
Hosako, Y., Nakamura, M., Tayama, N., Mizuno, M., Matsunaga, A., Niimi, S., Hirose, H., Hagino, S. (1993) Laryngeal involvements in systemic lupus erythematosus. Larynx Japan 6: 171175.CrossRefGoogle Scholar
Lofgren, R. H., Montgomery, W. W. (1962) Incidence of laryngeal involvement in rheumatoid arthritis. New England Journal of Medicine 267: 193195.CrossRefGoogle ScholarPubMed
Schwartz, I. S., Grishman, E. (1980) Rheumatoid nodules of the vocal cords as the initial manifestation of systemic lupus erythematosus. Journal of the American Medical Association 244: 27512752.Google Scholar
Webb, J., Payne, W. H. (1972) Rheumatoid nodules of the vocal folds. Annals of Rheumatic Disease 31: 122125.CrossRefGoogle ScholarPubMed