Pulmonary involvement in Sweet’s syndrome(SS)is rare.We report a case of SS with severe respiratory involvement responding to corticosteroid therapy.A 82-year-old man presented fever of 39 °C associated with cou...Pulmonary involvement in Sweet’s syndrome(SS)is rare.We report a case of SS with severe respiratory involvement responding to corticosteroid therapy.A 82-year-old man presented fever of 39 °C associated with cough and dyspnea,and crackles in the left lung.The infection work-up was negative.Chest X-ray showed cardiomegaly and left lower lobe pulmonary infiltrates.Pulmonary signs did not improve on treatment with antibiotics,and after 1 week maculopapular lesions appeared,localized on the knees,the periombilical area and the back.The antibiotics were changed without improvement.A skin biopsy revealed infiltration by neutrophilic granulocytes and marked edema in the dermis,consistent with SS.The patient’s condition progressively worsened,requiring high oxygenotherapy,and he was transferred to an intensive care unit.Chest X-ray revealed an important alveolar and interstitial syndrome.Bronchoalveolar lavage found 170 leukocytes with 30%neutrophils(N < 5%),7%lymphocytesand 63%macrophages.A search for bacteria,virusesor parasites in bronchoalveolar lavage was negative.The patientwas treated with antibiotics,a high dose of furosemide and steroids for 4 days.Because the patient improved dramatically within 5 days,with a negative infection work-up and a dramatic decrease of C-reactive protein,the antibioticswere stopped.Steroids were secondarily tapered very slowly.A chest computed tomography(CT)scan showed a substantial improvement of pulmonary lesions.We also review the 22 cases of pulmonary involvement of SS reported in the literature.展开更多
Sweet’s syndrome is extremely rare in relapsing polychondritis. We report a rare case of Sweet’s syndrome revealing relapsing polychondritis. A 77-year -old man presented with fever, associated with respiratory symp...Sweet’s syndrome is extremely rare in relapsing polychondritis. We report a rare case of Sweet’s syndrome revealing relapsing polychondritis. A 77-year -old man presented with fever, associated with respiratory symptoms and non pr uritic, painful, erythematous, papules and plaquesmainly on the arms and legs. S kin biopsy of the arm found a neutrophilic dermal infiltrate consistent with Swe et’s syndrome. A month and a half after admission, the patient presentedwith e ar chondritis and dysphonia. Biopsy of the ear cartilage found a significant per ichondral inflammatory cells infiltrate. The diagnosis of relapsing polychondrit iswas established and a steroid treatmentwas instituted with a complete regressi on of the cutaneous signs and chondritis.展开更多
文摘Pulmonary involvement in Sweet’s syndrome(SS)is rare.We report a case of SS with severe respiratory involvement responding to corticosteroid therapy.A 82-year-old man presented fever of 39 °C associated with cough and dyspnea,and crackles in the left lung.The infection work-up was negative.Chest X-ray showed cardiomegaly and left lower lobe pulmonary infiltrates.Pulmonary signs did not improve on treatment with antibiotics,and after 1 week maculopapular lesions appeared,localized on the knees,the periombilical area and the back.The antibiotics were changed without improvement.A skin biopsy revealed infiltration by neutrophilic granulocytes and marked edema in the dermis,consistent with SS.The patient’s condition progressively worsened,requiring high oxygenotherapy,and he was transferred to an intensive care unit.Chest X-ray revealed an important alveolar and interstitial syndrome.Bronchoalveolar lavage found 170 leukocytes with 30%neutrophils(N < 5%),7%lymphocytesand 63%macrophages.A search for bacteria,virusesor parasites in bronchoalveolar lavage was negative.The patientwas treated with antibiotics,a high dose of furosemide and steroids for 4 days.Because the patient improved dramatically within 5 days,with a negative infection work-up and a dramatic decrease of C-reactive protein,the antibioticswere stopped.Steroids were secondarily tapered very slowly.A chest computed tomography(CT)scan showed a substantial improvement of pulmonary lesions.We also review the 22 cases of pulmonary involvement of SS reported in the literature.
文摘Sweet’s syndrome is extremely rare in relapsing polychondritis. We report a rare case of Sweet’s syndrome revealing relapsing polychondritis. A 77-year -old man presented with fever, associated with respiratory symptoms and non pr uritic, painful, erythematous, papules and plaquesmainly on the arms and legs. S kin biopsy of the arm found a neutrophilic dermal infiltrate consistent with Swe et’s syndrome. A month and a half after admission, the patient presentedwith e ar chondritis and dysphonia. Biopsy of the ear cartilage found a significant per ichondral inflammatory cells infiltrate. The diagnosis of relapsing polychondrit iswas established and a steroid treatmentwas instituted with a complete regressi on of the cutaneous signs and chondritis.
