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Hoarseness as the initial manifestation of systemic lupus erythematosus

  • Koichi Tsunoda (a1) and Yasushi Soda (a2)

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.

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Corresponding author

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

References

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Friedman, B. A., Rice, D. H. (1975) Rheumatoid nodules of the larynx. Archives of Otolaryngology 101: 361363.
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.
Lofgren, R. H., Montgomery, W. W. (1962) Incidence of laryngeal involvement in rheumatoid arthritis. New England Journal of Medicine 267: 193195.
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.
Webb, J., Payne, W. H. (1972) Rheumatoid nodules of the vocal folds. Annals of Rheumatic Disease 31: 122125.

Keywords

Hoarseness as the initial manifestation of systemic lupus erythematosus

  • Koichi Tsunoda (a1) and Yasushi Soda (a2)

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