Background/Aims A 65-year-old man with a 20-year history of rheumatoid arthritis (RA) presented with dysphagia, odynophagia, polyarthralgia and significant weight loss. Methods - Results In addition to raised markers of inflammation, he was anti-nuclear antibody, anti-dsDNA antibody, anti-chromatin antibody and rheumatoid factor positive. He was initiated on 20mg once daily prednisolone but reported continued dysphagia and odynophagia. Computerised tomography (CT) of the neck revealed sclerosis at both cricoarytenoid joints with positron emission tomography (PET-CT) imaging identifying focal FDG uptake in the right hemiglottis projected over the posterior right true cord. Direct visualisation showed reduced mobility of the arytenoids with incomplete glottic closure in the absence of other abnormalities. He was diagnosed with cricoarytenoid (CA) joint arthritis on a background of RA and systemic lupus erythematosus overlap, with the resolution of his symptoms following intravenous methylprednisolone. Conclusion CA arthritis is an increasingly rare manifestation of autoimmune disease, and severe ongoing odynophagia an atypical presentation. This case highlights the need for continued awareness of laryngeal manifestations of autoimmune disease and demonstrates the benefit of PET-CT in cases where the diagnosis is uncertain or delayed. Disclosure J.S. Berry: None. J. Robinson: None. W. Ng: Consultancies; Expert advice in the area of Sjogren’s syndrome to GlaxoSmithKline, MedImmune, UCB, Abbvie, Roche, Eli Lilly, Takeda, Resolves Therapeutics, Sanofi, Novartis and BMS.

中文翻译：

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E026 类风湿关节炎和系统性红斑狼疮患者因环杓关节炎引起的严重吞咽疼痛

背景/目的 一名 65 岁男性，有 20 年类风湿关节炎 (RA) 病史，表现为吞咽困难、吞咽痛、多关节痛和体重明显减轻。方法-结果 除了炎症标志物升高外，他的抗核抗体、抗 dsDNA 抗体、抗染色质抗体和类风湿因子均呈阳性。他开始每天服用一次 20 毫克泼尼松龙，但报告有持续的吞咽困难和吞咽痛。颈部计算机断层扫描 (CT) 显示两个环杓关节出现硬化，正电子发射断层扫描 (PET-CT) 成像显示右侧半声门有局灶性 FDG 摄取，投射到右后真索上。直接可视化显示，在没有其他异常的情况下，杓状软骨的活动性降低，声门闭合不完全。他在 RA 和系统性红斑狼疮重叠的背景下被诊断为环杓状 (CA) 关节关节炎，静脉注射甲泼尼龙后症状得到缓解。结论 CA 关节炎是一种越来越罕见的自身免疫性疾病表现，而严重的持续性吞咽痛是一种非典型表现。该病例强调需要持续认识自身免疫性疾病的喉部表现，并证明 PET-CT 在诊断不确定或延迟的情况下的益处。披露 JS Berry：无。 J·罗宾逊：没有。 W. Ng：咨询；干燥综合征领域向葛兰素史克、MedImmune、UCB、艾伯维、罗氏、礼来、武田、Resolves Therapeutics、赛诺菲、诺华和百时美施贵宝提供专家建议。