Rheumatoid nodules and reflux disease.A 21 -year-old singer with perennial allergies and reflux disease came to us with a l-year history of reduced range and a raspy rasp·y adj. rasp·i·er, rasp·i·est Rough; grating. Adj. 1. raspy - unpleasantly harsh or grating in sound; "a gravelly voice" grating, rasping, gravelly, scratchy, rough speaking voice. On initial examination, she exhibited moderate vocal fold edema edema (ĭdē`mə), abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts. and erythema erythema (ĕr'əthē`mə), more or less diffuse redness of the skin due to concentration of an abnormally large amount of blood within the small vessels of the skin (hyperemia), as in burns. . She was prescribed a proton-pump inhibitor and an H2 blocker. A pH probe performed during therapy revealed that she was not having any breakthrough acid events. On follow-up stroboscopy, the generalized edema had resolved, but several yellow subepithelial nodules Nodules A small mass of tissue in the form of a protuberance or a knot that is solid and can be detected by touch. Mentioned in: Leprosy were noted on both vocal folds. On further questioning, the patient admitted that she had arthritis in her hands that was severe enough to prevent her from playing her harp. She underwent a rheumatologic evaluation and was found to be positive for antinuclear antibodies (1:320); although her rheumatoid factor was negative, she was placed on hydroxyehloroquine sulfate therapy. She improved dramatically, and the nodules began to resolve. From the Texas Voice Center, Houston. |
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