HOARSENESS AS THE INITIAL MANIFESTATION OF SYSTEMIC LUPUS-ERYTHEMATOSUS

A 51-year-old woman complained of hoarseness of two years duration. Th e patient's Cast medical history was significant fur autoimmunological hepatitis and arthritis fur which she had nor received treatment. Lar yngoscopy and laryngeal stroboscopy revealed 'bamboo joint-like nodule s' on both true vocal folds, These nodules resembled rheumatoid nodule s and were suggestive of a collagen disease. Previous reports have doc umented chat the treatment for such conditions related to collagen dis eases is surgical resection. However, we initially attempted to treat tile 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 arthriti s completely resolved. Based on our patient's response to this treatme nt, Eve diagnosed atypical-SLE and a lupus laryngitis. This case sugge sts that studies of the larynx may be helpful in the early diagnosis o f collagan diseases and that such conditions may respond to systemic t reatment.