Bamboo node as an unusual cause of Dysphonia in a Filipino patient with mixed Connective Tissue Disease

John Elmer C Quilisadio; Evelyn O Salido; Ryner Jose D Carillo; Daryl Anne A Del Mundo

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Bamboo node as an unusual cause of Dysphonia in a Filipino patient with mixed Connective Tissue Disease

Author: John Elmer C. Quilisadio ¹ ; Evelyn O. Salido ² ; Ryner Jose D. Carillo ³ ; Daryl Anne A. Del Mundo ⁴
Author Information

1. Fellow-in-training, Section of Rheumatology, Department of Medicine, University of the Philippines Manila-Philippine General Hospital, Manila, Philippines
2. Head, Section of Rheumatology, Department of Medicine, University of the Philippines Manila-Philippine General Hospital, Manila, Philippines
3. Consultant, Department of Otorhinolarnygology and Department of Anatomy, University of the Philippines- College of Medicine, Manila, Philippines
4. Resident-in-training, Department of Otorhinolarnygology/ Head and Neck Surgery, University of the Philippines- Philippine General Hospital, Manila, Philippines
Publication Type:Case Reports
Keywords: Bamboo nodes; Mixed connective tissue disorder; Filipino; Case report
MeSH: Dysphonia
From: Philippine Journal of Internal Medicine 2020;58(1):34-38
CountryPhilippines
Language:English
Abstract: Introduction:Bamboo node is a rare vocal cord pathology causing dysphonia among patients with autoimmune disorders. These “bamboo-joint-like” transverse deposits on the vocal cords interfere with the vibratory cycle during phonation leading to voice hoarseness. A review of Schwemmle from 1993-2009, showed seven cases of bamboo node among patients with mixed connective tissue disease (MCTD). With the patient’s consent, this case is presented to contribute to current knowledge about MCTD.
Case Presentation:A 36-year-old Filipino female developed voice hoarseness one year after she was diagnosed with MCTD. Videostroboscopic findings revealed bilateral bamboo nodes, vibratory defects, and amplitude abnormalities. Treatment with prednisone, methotrexate, hydroxychloroquine, along with voice rest and speech therapy resulted in normalization of amplitude, mucosal wave and vibratory behavior during repeat videostroboscopy.
Conclusion:To date, this is the first known case of bamboo nodes associated with MCTD in a Filipino patient. This case highlights the importance of properly investigating the symptom of hoarseness among patients with rheumatologic diseases. A multidisciplinary approach involving the rheumatologist, otorhinolaryngologist, and speech therapist play an important role in the complete care of this patient.
Full text:9Bamboo-Node.pdf