The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Diffuse Idiopathic Skeletal Hyperostosis Presenting with Dysphagia Secondary to Cervical Osteophyte and Restrictive Ventilatory Impairment

미만특발골격뼈과다증 환자에서 경추부 골극에 의한 삼킴곤란 및 제한성 환기장애가 동시에 발생한 1예

  • Lee, Hong Jik (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Lee, Ji Hyun (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Kim, Min Jeong (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Byun, Ki Sup (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Yeo, Hyun Jung (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Im, Ho Joon (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center) ;
  • Nam, Kyoung Sik (Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center)
  • 이홍직 (메리놀병원 류마티스내과) ;
  • 이지현 (메리놀병원 류마티스내과) ;
  • 김민정 (메리놀병원 류마티스내과) ;
  • 변기섭 (메리놀병원 류마티스내과) ;
  • 여현정 (메리놀병원 류마티스내과) ;
  • 임호준 (메리놀병원 류마티스내과) ;
  • 남경식 (메리놀병원 류마티스내과)
  • Received : 2013.06.25
  • Accepted : 2013.10.28
  • Published : 2014.07.01
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Abstract

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of soft tissue, and can lead to severe cervical kyphosis, presenting with a spectrum of physical complaints including dysphagia, hoarseness, stridor, aspiration pneumonia, and dyspnea due to airway compromise. Restrictive ventilatory impairment is very rare. We encountered a 73-year-old man with DISH presenting with progressive dysphagia and dyspnea over a few months. The symptoms were evaluated with a video fluoroscopy swallowing study and pulmonary function tests (PFT). The PFT revealed restrictive ventilatory impairment. A neck magnetic resonance imaging (MRI) study showed anterior cervical osteophytes causing upper airway compromise and compression of the esophagus. Osteophytes were removed surgically and the patient improved clinically. Here, we describe the case with a literature review.

DISH에서의 삼킴곤란은 주로 인두나 식도의 기계적 압박에 의하며 호흡곤란은 대부분 기도의 기계적 압박에 의해 발생한다. 저자들은 DISH 환자에서 경추부 골극에 의한 삼킴곤란 및 제한성 환기장애로 인한 호흡곤란이 동시에 발생한 경우를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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