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Mesolella M, Allosso S, Petruzzi G, Motta G. Subglottic Mass as Isolated Manifestation of Relapsing Polychondritis at Presentation. EAR, NOSE & THROAT JOURNAL 2023; 102:NP440-NP445. [PMID: 34082611 DOI: 10.1177/01455613211016718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Relapsing polychondritis (RP) is a rare systemic disease that is characterized by recurrent episodic inflammation of the cartilaginous structures of the body, resulting in their progressive destruction and subsequent replacement with fibrotic scar. We present a case of RP that initially manifested with subglottic involvement and we propose an innovative strategy for the treatment for laryngeal RP in phase of active inflammation. A multidisciplinary approach (rheumatologist, otolaryngologist, immunologist, internist, cardiologist, etc) and adequate follow-up are essential. The timeliness of the diagnosis is fundamental to contain the destructive effects on the cartilages involved.
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Affiliation(s)
- Massimo Mesolella
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | - Salvatore Allosso
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | - Gerardo Petruzzi
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Gaetano Motta
- Unit of Otorhinolaryngology, University Luigi Vanvitelli, Napoli, Italy
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Wang D, Guan L, Dong X, Zhu X, Tong Z. Comparison of relapsing polychondritis patients with and without respiratory involvement based on chest computed tomography: a retrospective cohort study. BMC Pulm Med 2022; 22:222. [PMID: 35676691 PMCID: PMC9175384 DOI: 10.1186/s12890-022-01955-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relapsing polychondritis (RP) patients with tracheal cartilage involvement are different from other patients. The objective of this study was to compare the clinical features and disease patterns between a respiratory involvement subgroup and a non-respiratory involvement subgroup according to chest computed tomography. METHOD We performed a retrospective cohort study collecting RP patients hospitalized at the Beijing Chao-Yang Hospital between January 2012 and August 2021. RESULTS Respiratory involvement affected 59.7% of patients in our cohort. The incidence of costochondritis was more common in RP patients with respiratory involvement (p = 0.03); the incidence of inflammatory eye disease (p = 0.001) and auricular chondritis (p = 0.001) was less frequent in RP respiratory involvement patients.. Compared with the non-respiratory involvement subgroup the incidence of pulmonary infection marginally increased in the respiratory involvement subgroup (p = 0.06). Inflammatory indexes except for C-reactive protein to albumin ratio (CAR) were significantly higher in the respiratory involvement subgroup; analysis revealed no significant relationship between inflammatory indexes and pulmonary infection. CONCLUSION RP patients with respiratory involvement had a greater incidence of costochondritis and pulmonary infectionand lesser incidence of inflammatory eye diseases and auricular chondritis compared to non-respiratory involvement. Increasing inflammatory indexes suggests that patients with respiratory involvement had a higher disease activity index of RP. The difference in probability of survival was insignificant between subgroups.
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Affiliation(s)
- Dong Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlua, Chaoyang District, Beijing, 100020, China
| | - Lujia Guan
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlua, Chaoyang District, Beijing, 100020, China
| | - Xin Dong
- Department of Rheumatology and Autoimmune Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaofan Zhu
- Department of Medical Records Division, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlua, Chaoyang District, Beijing, 100020, China.
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Erdogan M, Esatoglu SN, Hatemi G, Hamuryudan V. Aortic involvement in relapsing polychondritis: case-based review. Rheumatol Int 2019; 41:827-837. [PMID: 31768631 DOI: 10.1007/s00296-019-04468-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/25/2019] [Indexed: 12/22/2022]
Abstract
Relapsing polychondritis is a systemic inflammatory disease that mainly affects ears, nose, eyes, joints, and large airway. Relapsing polychondritis may also affect cardiac valves and large vessels with the aorta being most frequently involved. We conducted a systematic literature review to delineate the clinical characteristics, treatment, and outcome of relapsing polychondritis patients with aortic involvement including thoracic and abdominal aorta, aortic valve, and coronary arteries. 113 patients reported in 85 manuscripts were retrieved through the systematic literature search and references of the selected manuscripts. With the addition of a patient from our center, a total of 114 patients were included in the analyses. Aortic vessel involvement was the predominant type of involvement that was identified in 93 (82%) patients, while aortic valve involvement was identified in 41 patients (36%). The median age at aortic involvement was 37 years [IQR: 30-53] with a delay of 5 years [IQR: 1-8] between first relapsing polychondritis symptom and aortic involvement. Nineteen percent of the patients were asymptomatic at the time of aortic involvement diagnosis. The initial treatment was immunosuppressives in 41 patients (56%) and surgery in 28 patients (38%). The mortality ratio was 27% in a 24 month follow-up [IQR: 7.5-54 months]. Aortic dissection or rupture was the most frequent causes of mortality. Concomitant coronary artery involvement suggested a worse outcome. Aortic involvement in relapsing polychondritis is a mortal complication despite medical and surgical treatments. It may be asymptomatic in 19% of the patients which warrants the importance of screening.
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Affiliation(s)
- Mustafa Erdogan
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University - Cerrahpasa, Cerrahpasa, 34998, Istanbul, Turkey
| | - Sinem Nihal Esatoglu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University - Cerrahpasa, Cerrahpasa, 34998, Istanbul, Turkey
| | - Gulen Hatemi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University - Cerrahpasa, Cerrahpasa, 34998, Istanbul, Turkey
| | - Vedat Hamuryudan
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University - Cerrahpasa, Cerrahpasa, 34998, Istanbul, Turkey.
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Tajiri M, Tominaga M, Kinoshita T, Nakamura M, Kaieda S, Okamoto M, Ida H, Kawayama T, Hoshino T. Clinical Characteristics of Relapsing Polychondritis: A Report of 8 Cases in Japan. Kurume Med J 2019; 65:47-53. [PMID: 30853688 DOI: 10.2739/kurumemedj.ms652006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Relapsing polychondritis (RP) is a very rare autoimmune disorder characterized by recurrent episodes of inflammation and destruction of cartilaginous tissues. We examined the clinical characteristics, management, and outcomes of Japanese RP patients. METHODS We identified 8 RP cases in our department between 2003 and 2017. Detailed clinical features, testing, treatment, and outcomes were recorded. RESULTS The mean time from symptom onset to diagnosis was 9 months. Four cases presented with auricular chondritis and laryngotracheal involvement and 3 cases presented with a saddle nose deformity. Anti-type II collagen antibody was positive in 5 of 6 cases. Of 3 cases with associated diseases (rheumatoid arthritis, ulcerative colitis, and Sjögren's syndrome), 2 died of respiratory failure. CONCLUSIONS When RP is diagnosed, early computed tomography or pulmonary function testing is essential to enable early treatment. Undiagnosed airway involvement can cause tracheobronchial wall fibrosis, leading to fixed stenosis.
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Affiliation(s)
- Morihiro Tajiri
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Masaki Tominaga
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Takashi Kinoshita
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Masayuki Nakamura
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Shinjiro Kaieda
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Masaki Okamoto
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Hiroaki Ida
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Tomotaka Kawayama
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
| | - Tomoaki Hoshino
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine
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Xu Q, Luo H, Zuo X, Liu S. Case report of mixed-type autoimmune hemolytic anemia in a patient with relapsing polychondritis. Medicine (Baltimore) 2018; 97:e12716. [PMID: 30290676 PMCID: PMC6200522 DOI: 10.1097/md.0000000000012716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Relapsing polychondritis (RP) is a rare autoimmune-related disease and may be associated with other autoimmune diseases. PATIENT CONCERNS Here we reported a case of RP patients with mixed-type AIHA. The patient was diagnosed with RP in March 2008 which was treated and the patient was in stable condition. Laboratory data revealed progressive decrease in hemoglobin during her hospitalization due to pulmonary infection in 2016. Positive Coombs' test and moderate titer of anti-cold agglutinin was detected. DIAGNOSIS Mixed-type AIHA was diagnosed as a comorbidity in this case given the circumstance that her RP was stable and low-dose oral corticosteroids was enough to maintain remission. INTERVENTIONS The patient was treated with intravenous immunoglobulin and steroids. OUTCOMES The patient's body temperature dropped and hemoglobin levels rose in 2 weeks. LESSONS Reports of RP patients with autoimmune hemolytic anemia (AIHA) are extremely rare and cases with the mixed-type AIHA has not been reported. Here we describe a case of RP with mixed-type AIHA which was considered as a comorbidity rather than a complication.
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Affiliation(s)
- Qianyun Xu
- Department of Rheumatology and Immunology, Xiangya Hospital
- The Institution of Rheumatology and Immunology, Central South University, Changsha, Hunan, China
| | - Hui Luo
- Department of Rheumatology and Immunology, Xiangya Hospital
- The Institution of Rheumatology and Immunology, Central South University, Changsha, Hunan, China
| | - Xiaoxia Zuo
- Department of Rheumatology and Immunology, Xiangya Hospital
- The Institution of Rheumatology and Immunology, Central South University, Changsha, Hunan, China
| | - Sijia Liu
- Department of Rheumatology and Immunology, Xiangya Hospital
- The Institution of Rheumatology and Immunology, Central South University, Changsha, Hunan, China
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Pallo PAO, Levy‐Neto M, Pereira RMR, Shinjo SK. Policondrite recidivante: prevalência de doenças cardiovasculares e seus fatores de risco e características gerais da doença de acordo com o gênero. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pallo PAO, Levy-Neto M, Pereira RMR, Shinjo SK. Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:338-345. [PMID: 28743361 DOI: 10.1016/j.rbre.2017.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/11/2017] [Indexed: 10/20/2022] Open
Abstract
The comorbidities in relapsing polychondritis have been scarcely described in the literature. Moreover, apart from a few relapsing polychondritis epidemiological studies, no studies specifically addressing relapsing polychondritis distribution according to gender are available. Therefore, the objectives of the present study were: (a) to analyze the prevalence of cardiovascular diseases and its risk factors in a series of patients with relapsing polychondritis; (b) to determine the influence of gender on relapsing polychondritis. A cross-sectional tertiary single center study evaluating 30 relapsing polychondritis cases from 1990 to 2016 was carried out. To compare comorbidities, 60 healthy individuals matched for age-, gender-, ethnicity- and body mass index were recruited. The mean age of relapsing polychondritis patients was 49.0±12.4 years, the median disease duration 6.0 years, and 70% were women. A higher frequency of arterial hypertension (53.3% vs. 23.3%; p=0.008) and diabetes mellitus (16.7% vs. 3.3%; p=0.039) was found in the relapsing polychondritis group, compared to the control group. As an additional analysis, patients were compared according to gender distribution (9 men vs. 21 women). The clinical disease onset features were comparable in both genders. However, over the follow-up period, male patients had a greater prevalence of hearing loss, vestibular disorder and uveitis events, and also received more cyclophosphamide therapy (p<0.05). There was a high prevalence of arterial hypertension and diabetes mellitus, and the male patients seemed to have worse prognosis than the female patients in the follow up.
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Affiliation(s)
- Pablo Arturo Olivo Pallo
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
| | - Maurício Levy-Neto
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
| | | | - Samuel Katsuyuki Shinjo
- Universidade de São Paulo, Faculdade de Medicina, Disciplina de Reumatologia, São Paulo, SP, Brazil.
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Orbital Relapsing Polychondritis: A Unique Presentation, Complication, and Treatment. Ophthalmic Plast Reconstr Surg 2016; 32:e34-6. [PMID: 25072220 DOI: 10.1097/iop.0000000000000222] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
An 87-year-old man with a history of relapsing polychondritis presented to the emergency department after 4 days of worsening left periorbital swelling and erythema. On examination, he demonstrated clinical features consistent with orbital cellulitis and was treated with a trial of intravenous antibiotics. His condition did not improve over the next 36 hours and intravenous methylprednisolone was initiated. This led to rapid improvement in orbital symptoms and signs, and a diagnosis of specific orbital inflammation secondary to relapsing polychondritis was made. The patient was discharged on a tapering dose of prednisone. As a steroid-sparing measure, adalimumab was initiated; however, the patient developed Sweet Syndrome. Adalimumab was subsequently discontinued, steroid dose was increased, and anakinra treatment was initiated. This therapeutic course led to significant clinical improvement. Since initiating anakinra, the patient has had no recurrences of Sweet Syndrome. Anakinra may be a useful adjunct therapy for ophthalmic manifestations of relapsing polychondritis.
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Lin DF, Yang WQ, Zhang PP, Lv Q, Jin O, Gu JR. Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature. Rheumatol Int 2016; 36:1003-9. [PMID: 26951051 DOI: 10.1007/s00296-016-3449-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 11/24/2015] [Indexed: 12/25/2022]
Abstract
This work is aimed to study the clinical and prognostic features of relapsing polychondritis (RP) in China. A total of 158 RP cases from 1985 to 2013 in China were included and compared with international case series in terms of clinical features, systemic involvement, differential diagnosis and prognosis. (1) The average age at the onset was 45.3 years old, the average age for initial symptoms was 14.4 months, female/male ratio was 0.7:1 and misdiagnosis rate was 47 %. (2) The incidence of arthritis was lower than that in Caucasians. The incidences of auricular chondritis (68 %: 84-95 %), ocular inflammation (44 %: 49-65 %) and renal involvement (3 %: 7-26 %) were lower, and laryngotracheal symptoms (69 %: 31-67 %), skin (46 %: 4-38 %) and neurological involvement (12 %: 2-8 %) were higher during the follow-up period. The proportion of associated autoimmune disease and systemic vasculitis were 5 and 3 %, respectively, similar to that in Japanese (4 and 2 %), but less than that in Caucasians (12-31 and 8-18 %) except the Francès's study (7 and 3 %). The primary death cause is respiratory failure due to RP, followed by lung infections and cardiovascular events. (3) Juvenile RP (onset ≤18 years) was more severe than adults, similar to results from the Caucasians. However, Chinese juvenile RP had more severe ocular inflammation (57 %: 40-47 %), arthritis (100 %: 71-90 %), cardiovascular (14 %: 3-10 %) and skin involvement (20 %: 10-11 %) than Caucasian juvenile RP. Although sharing most of the clinical features with case series in previous literature, Chinese patients with RP have its unique characteristics.
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Affiliation(s)
- Dong-Fang Lin
- The Rheumatology Division, The 3rd Affiliated Hospital of Sun Yat-sen University, No 600, Tian-he Road, Guangzhou City, 510630, Guangdong Province, China.
| | - Wei-Qiang Yang
- The ENT Division, Ever in the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China.,Peking University Shenzhen Hospital, Shenzhen, China
| | - Ping-Ping Zhang
- The Pediatrics Division, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
| | - Qing Lv
- The Pediatrics Division, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
| | - Ou Jin
- The Pediatrics Division, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
| | - Jie-Ruo Gu
- The Pediatrics Division, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou City, China
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Sharma A, Law AD, Bambery P, Sagar V, Wanchu A, Dhir V, Vijayvergiya R, Sharma K, Gupta A, Panda NK, Singh S. Relapsing polychondritis: clinical presentations, disease activity and outcomes. Orphanet J Rare Dis 2014; 9:198. [PMID: 25527201 PMCID: PMC4302515 DOI: 10.1186/s13023-014-0198-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/20/2014] [Indexed: 11/10/2022] Open
Abstract
Background Relapsing polychondritis is a rare disease characterised by inflammation of cartilaginous and proteoglycan rich structures. As there are only a few published single centre case series from all across the world, we describe our experience with 26 patients at a tertiary centre in north India. Methods A retrospective study with all patients meeting Damiani and Levine’s modification of McAdam’s diagnostic criteria. Clinical details, investigations, disease activity assessment [(Relapsing Polychondritis Disease Activity Index (RPDAI)], treatment and outcomes were recorded. Results Ten men and sixteen women (median age 45 years) met the diagnostic criteria. Auricular chondritis (96%), arthritis (54%), hearing impairment (42%), ocular (42%), dermal (26%), cardiovascular (11%) and laryngotracheal involvement (11%) characterized the clinical presentations. The median RPDAI was 31 (range 9-66). Two patients died during observation. Overall survival was 92.3% (median survival 13.5 years). Conclusions Apart from reduced laryngotracheal involvement, RP in India was clinically similar to recorded patterns elsewhere.
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Affiliation(s)
- Aman Sharma
- Department of Internal Medicine, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Arjun Dutt Law
- Department of Internal Medicine, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Pradeep Bambery
- University of Queensland, Bundaberg Hospital, Bundaberg, Australia.
| | - Vinay Sagar
- Department of Internal Medicine, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Ajay Wanchu
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA.
| | - Varun Dhir
- Department of Internal Medicine, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Rajesh Vijayvergiya
- Department of Cardiology, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Kusum Sharma
- Department of Medical Microbiology, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Ashok Gupta
- Department of Otorhinolaryngology, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Naresh K Panda
- Department of Otorhinolaryngology, Postgraduate Institute of medical education and research, Chandigarh, India.
| | - Surjit Singh
- Department of Internal Medicine, Postgraduate Institute of medical education and research, Chandigarh, India.
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Lei W, Zeng DX, Chen T, Jiang JH, Wang CG, Zhu YH, Huang JA. FDG PET-CT combined with TBNA for the diagnosis of atypical relapsing polychondritis: report of 2 cases and a literature review. J Thorac Dis 2014; 6:1285-92. [PMID: 25276371 DOI: 10.3978/j.issn.2072-1439.2014.08.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 07/31/2014] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To explore the value of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) combined with transbronchial needle aspiration (TBNA) in diagnosing atypical relapsing polychondritis (RP). METHODS Data from two patients with atypical RP, which had been diagnosed in our hospital using FDG PET-CT combined with TBNA, were retrospectively analyzed. A review of the relevant literature was also performed. RESULTS Consistent with the previously reported 20 cases of RP that had been diagnosed using FDG PET-CT, the two patients in the present study showed the involvement of multiple organs, including the nose, throat, trachea, bronchi, costicartilage and joint cartilages, and increased FDG uptake was found in these areas. The mean value of SUVmax was 5.14. PET-CT revealed that 86.4% of the patients with RP had airway involvement. TBNA technique was used for biopsy of the hypermetabolic lesions, and pathologic examinations confirmed the diagnosis of RP. The time to diagnosis in these two patients and the 20 cases reported previously was about 6.9 months, significantly shorter than the average diagnosis time (20 months). CONCLUSIONS FDG PET-CT has several advantages for diagnosing RP, especially atypical RP. TBNA is a minimally invasive and safe technique for obtaining airway cartilage. Combining PET-CT with TBNA may play an important role in shortening the time to diagnosis in patients with RP involvement of airway.
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Affiliation(s)
- Wei Lei
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Da-Xiong Zeng
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Tao Chen
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Jun-Hong Jiang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Chang-Guo Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Ye-Han Zhu
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Jian-An Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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A Case of Red Ears. Am J Dermatopathol 2014. [DOI: 10.1097/dad.0b013e3182a415d1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cantarini L, Vitale A, Brizi MG, Caso F, Frediani B, Punzi L, Galeazzi M, Rigante D. Diagnosis and classification of relapsing polychondritis. J Autoimmun 2014; 48-49:53-9. [PMID: 24461536 DOI: 10.1016/j.jaut.2014.01.026] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/13/2013] [Indexed: 12/17/2022]
Abstract
Relapsing polychondritis is a rare and potentially fatal autoimmune disease of unknown etiology, characterized by inflammation and destruction of different cartilaginous structures, including the ear, nose, larynx, trachea, bronchi, peripheral joints, eye, heart and skin, with high risk of misdiagnosis. The spectrum of clinical presentations is protean and may vary from intermittent episodes of painful and disfiguring auricular and nasal chondritis or polyarthritis to severe progressive multi-organ damage. A laryngotracheobronchial involvement appears in nearly half of patients and is complicated by local obstructions, which may be life-threatening. A highly medical specialized approach is required for diagnosis of relapsing polychondritis. This review comprehensively examines the literature related to the clinical sceneries of the disease and focuses on both diagnostic tools used in clinical studies and recent findings related to its etiopathogenesis.
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Affiliation(s)
- Luca Cantarini
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy.
| | - Antonio Vitale
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Maria Giuseppina Brizi
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Francesco Caso
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
| | - Bruno Frediani
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Leonardo Punzi
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
| | - Mauro Galeazzi
- Interdepartmental Research Center of Systemic Autoimmune and Autoinflammatory Diseases, Rheumatology Unit, Policlinico Le Scotte, University of Siena, Siena, Italy
| | - Donato Rigante
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Rome, Italy
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Oka H, Yamano Y, Shimizu J, Yudoh K, Suzuki N. A large-scale survey of patients with relapsing polychondritis in Japan. Inflamm Regen 2014. [DOI: 10.2492/inflammregen.34.149] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Relapsing polychondritis: a review. Clin Rheumatol 2013; 32:1575-83. [DOI: 10.1007/s10067-013-2328-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 06/26/2013] [Indexed: 12/18/2022]
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Arnaud L, Devilliers H, Peng SL, Mathian A, Costedoat-Chalumeau N, Buckner J, Dagna L, Michet C, Sharma A, Cervera R, Haroche J, Papo T, D'Cruz D, Arlet P, Zwerina J, Belot A, Suzuki N, Harle JR, Moots R, Jayne D, Hachulla E, Marie I, Tanaka T, Lebovics R, Scott D, Kucharz EJ, Birchall M, Kong KO, Gorochov G, Amoura Z. The Relapsing Polychondritis Disease Activity Index: Development of a disease activity score for relapsing polychondritis. Autoimmun Rev 2012; 12:204-9. [DOI: 10.1016/j.autrev.2012.06.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 06/23/2012] [Indexed: 01/08/2023]
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17
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18
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Mathew SD, Battafarano DF, Morris MJ. Relapsing Polychondritis in the Department of Defense Population and Review of the Literature. Semin Arthritis Rheum 2012; 42:70-83. [DOI: 10.1016/j.semarthrit.2011.12.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 12/17/2011] [Accepted: 12/27/2011] [Indexed: 01/05/2023]
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Yoo JH, Chodosh J, Dana R. Relapsing Polychondritis: Systemic and Ocular Manifestations, Differential Diagnosis, Management, and Prognosis. Semin Ophthalmol 2011; 26:261-9. [DOI: 10.3109/08820538.2011.588653] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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