1
|
Makus B, Rose T. [Relapsing poly chondritis]. Z Rheumatol 2023; 82:867-876. [PMID: 38012458 DOI: 10.1007/s00393-023-01451-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
Relapsing polychondritis (RP) is a rare multisystemic disease predominantly involving the extracellular matrix. Typical manifestations are chondritis of the ears, nose and trachea as well as an asymmetrical oligoarthritis or polyarthritis of small and also larger joints. Various other involvements have also been described. The treatment of RP is individually dependent on a variety of factors, e.g., organ manifestations. Glucocorticoids, immunosuppressants and targeted treatment are implemented. In the case of seronegative rheumatoid arthritis or vasculitis with an atypical course the symptoms of RP should be taken into consideration.
Collapse
Affiliation(s)
- Benjamin Makus
- Klinik für Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Charité Platz 1, 10117, Berlin, Deutschland
| | - Thomas Rose
- Klinik für Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Charité Platz 1, 10117, Berlin, Deutschland.
| |
Collapse
|
2
|
Curry JT, Wingard MT. Relapsing poly chondritis: an inflammatory disorder not to be missed. Clin Exp Optom 2021; 104:656-657. [PMID: 33689661 DOI: 10.1080/08164622.2021.1878849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Jeffery T Curry
- Optometry Department, Lake City Veterans Affairs Medical Center, Lake City, FL, USA
| | - Michael T Wingard
- Optometry Department, McAllen Veterans Affairs Community Based Outpatient Clinic, McAllen, TX, USA
| |
Collapse
|
3
|
Athlani L. Trapeziometacarpal joint ligament reconstruction in early stages of first carpometacarpal joint osteoarthritis. Hand Surg Rehabil 2021; 40S:S42-5. [PMID: 33401008 DOI: 10.1016/j.hansur.2020.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022]
Abstract
Trapeziometacarpal joint ligament reconstruction is a surgical option in the early stages of thumb basal joint arthritis when the joint is painful and unstable without chondropathy. Arthroscopy is invaluable here to ensuring the joint surfaces are intact, which is often underestimated by radiography. The Eaton-Littler procedure using a distally pedicled flexor carpi radialis slip has been studied the most in this context. This reconstruction provides pain relief while slowing the rapid development of osteoarthritis.
Collapse
|
4
|
Abstract
Docetaxel, derived from the yew tree, belongs to the taxane family of medications. It works by disrupting the normal function of microtubules, thereby stopping cell division. Docetaxel is used in the treatment of ovarian, breast, esophageal, gastric, prostate, lung, and head and neck cancers. Common side effects include hair loss, low blood cell counts, peripheral neuropathy, vomiting, and muscle pain. Auricular chondritis with ear deformity has not been reported previously as a side effect of docetaxel. In this paper, we present the case of a 64-year-old male patient with chondritis accompanied by ear deformity that developed due to docetaxel-carboplatin chemotherapy for non-small cell lung cancer.
Collapse
Affiliation(s)
- Tae Hoon Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Sung Min Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Young Joon Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Yonsei University, Wonju College of Medicine, Wonju, Korea
| |
Collapse
|
5
|
Mathian A, Miyara M, Cohen-Aubart F, Haroche J, Hie M, Pha M, Grenier P, Amoura Z. Relapsing poly chondritis: A 2016 update on clinical features, diagnostic tools, treatment and biological drug use. Best Pract Res Clin Rheumatol 2016; 30:316-33. [PMID: 27886803 DOI: 10.1016/j.berh.2016.08.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Relapsing polychondritis (RP) is a very rare autoimmune disease characterised by a relapsing inflammation of the cartilaginous tissues (joints, ears, nose, intervertebral discs, larynx, trachea and cartilaginous bronchi), which may progress to long-lasting atrophy and/or deformity of the cartilages. Non-cartilaginous tissues may also be affected, such as the eyes, heart, aorta, inner ear and skin. RP has a long and unpredictable course. Because no randomised therapeutic trials are available, the treatment of RP remains mainly empirical. Minor forms of the disease can be treated with non-steroidal anti-inflammatory drugs, whereas more severe forms are treated with systemic corticosteroids. Life-threatening diseases and corticosteroid-dependent or resistant diseases are an indication for immunosuppressant therapy such as methotrexate, azathioprine, mycophenolate mofetil and cyclophosphamide. Biologics could be given as second-line treatment in patients with an active disease despite the use of steroids and immunosuppressive drugs. Although the biologics represent new potential treatment for RP, very scarce information is available to draw any firm conclusion on their use in RP.
Collapse
|
6
|
Bellaud G, Canestri A, Gallah S, Merlant M, Cousseau S, Lebrette MG, Slama L, Pialoux G. Bacterial chondritis complications following ear piercing. Med Mal Infect 2016; 47:26-31. [PMID: 27596713 DOI: 10.1016/j.medmal.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Body piercing has become widespread and is associated with increased complications. Post-piercing chondritis may lead to severe residual deformity. We aimed to report case patients presenting with post-piercing chondritis in our department and to describe clinical features and treatment. PATIENTS AND METHODS We conducted a retrospective study of patients presenting with post-piercing chondritis in the infectious disease department of Tenon Hospital, Paris, France. RESULTS We included 21 patients. Fifteen bacteriological cultures were positive (7 Pseudomonas aeruginosa, 5 Staphylococcus aureus, and three other). Dual intravenous antibiotic therapy was administered to 13 patients for a median duration of six days [2-8], replaced by an oral antibiotic therapy for a median duration of 15 days [7-40]. Eight patients received oral antibiotic monotherapy for 10 days [7-30]. Median duration of antibiotic therapy was 16 days. Earring removal was performed for 18 patients. No ear deformity or general complication was reported. CONCLUSION Transcartilaginous ear piercing may lead to infectious complications or deformity. In case of chondritis, early administration of an antibiotic therapy active against P. aeruginosa and S. aureus is recommended. Specific guidelines are needed.
Collapse
Affiliation(s)
- G Bellaud
- Infectious diseases department, Pierre-et-Marie-Curie University, Tenon Hospital, Paris, France; Infectious diseases department, Tenon Hospital, Paris, France.
| | - A Canestri
- Infectious diseases department, Tenon Hospital, Paris, France
| | - S Gallah
- Department of bacteriology, Tenon Hospital, Paris, France
| | - M Merlant
- Infectious diseases department, Tenon Hospital, Paris, France
| | - S Cousseau
- Infectious diseases department, Tenon Hospital, Paris, France
| | - M G Lebrette
- Infectious diseases department, Tenon Hospital, Paris, France
| | - L Slama
- Infectious diseases department, Tenon Hospital, Paris, France
| | - G Pialoux
- Infectious diseases department, Pierre-et-Marie-Curie University, Tenon Hospital, Paris, France; Infectious diseases department, Tenon Hospital, Paris, France.
| |
Collapse
|
7
|
Longo L, Greco A, Rea A, Lo Vasco VR, De Virgilio A, De Vincentiis M. Relapsing poly chondritis: A clinical update. Autoimmun Rev 2016; 15:539-43. [PMID: 26876384 DOI: 10.1016/j.autrev.2016.02.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/08/2016] [Indexed: 02/07/2023]
Abstract
Relapsing polychondritis (RP) is a rare connective tissue disease in which recurrent bouts of inflammation, involve the cartilage of the ears, nose, larynx, tracheobronchial tree and cardiovascular system. RP is generally observed in the fourth and fifth decades of life and occurs with equal frequency in both sexes. The cause of RP is still unknown. It is considered an immune-mediated disease, as there is an overlap between well documented RP with other rheumatic and autoimmune diseases. There is a significant association of RP with the antigen HLA-DR4. RP includes loss of basophilic staining of cartilage matrix perichondral accompanied by inflammation of the cartilage. Cells are present perivascular mononuclear and polymorphonuclear cells infiltrated. The chondrocytes become vacuolated and necrotic and are replaced by fibrous tissue. Common symptoms are often absent in the early stages of the disease in almost half the cases, resulting in delay in diagnosis. The development of chondrite allows the diagnosis of RP in patients initially evaluated for joint abnormalities, ocular, cutaneous, or audio-vestibular. Diagnostic criteria for RP are based on characteristic clinical manifestations. According to Damiani and Levine, the diagnosis can be considered final when one or more of the clinical features are present in conjunction with biopsy confirmation. The course of symptoms for patients with relapsing polychondritis is often unpredictable. Patients with mild signs of acute inflammation are usually treated with non-steroidal anti-inflammatory drugs and small doses of prednisone. Patients with severe manifestations, such as airway compromise may require high doses of prednisone or even intravenous pulse methyl-prednisone.
Collapse
Affiliation(s)
- Lucia Longo
- Department Organs of Sense, Phoniatrics Section, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy
| | - Antonio Greco
- Department Organs of Sense, ENT Section, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy
| | - Andrea Rea
- Department Organs of Sense, Phoniatrics Section, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy
| | - Vincenza Rita Lo Vasco
- Department Organs of Sense, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy
| | - Armando De Virgilio
- Department Organs of Sense, ENT Section, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy.
| | - Marco De Vincentiis
- Department Organs of Sense, ENT Section, 'Sapienza' University of Rome, Viale del Policlinico 155, 00100 Roma, Italy
| |
Collapse
|
8
|
Guérin C, Grasland A, Touam M, Mahé I. [A rare cause of chondritis]. Rev Med Interne 2015; 36:142-4. [PMID: 25112805 DOI: 10.1016/j.revmed.2014.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/10/2014] [Accepted: 04/18/2014] [Indexed: 11/22/2022]
|
9
|
Moon SY, Lee JA, Joung MK, Chung DR, Song JH, Peck KR. Nasal deformity due to tuberculous chondritis. Clin Exp Otorhinolaryngol 2014; 7:229-31. [PMID: 25177442 DOI: 10.3342/ceo.2014.7.3.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 02/22/2013] [Accepted: 03/26/2013] [Indexed: 11/13/2022] Open
Abstract
Tuberculosis (TB) is a common disease worldwide. However, nasal TB is quite rare, and the diagnosis of nasal TB requires a high index of suspicion. The most common symptoms of this unusual presentation are nasal obstruction and nasal discharge. We present a case of nasal TB with involvement of the hard palate presenting with a chronically progressive nasal deformity and ulceration of the hard palate. A biopsy confirmed the diagnosis, and medication for TB was started and the lesions resolved. When a patient presents with chronic ulcerative lesions that do not respond to antibiotic treatment, TB should be included in the differential diagnosis. Biopsy of the lesion can aid in the confirmation of the diagnosis.
Collapse
|
10
|
Anchan SV, Garag SS, J S A, Prasad KC, Sharma PV. An interesting case of relapsing poly chondritis in a young girl. J Clin Diagn Res 2013; 7:2976-7. [PMID: 24551697 DOI: 10.7860/jcdr/2013/6651.3815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 10/19/2013] [Indexed: 11/24/2022]
Abstract
Relapsing polychondritis is an acute, recurrent and progressive inflammation and degeneration of cartilage and connective tissue including that within the tracheobronchial tree affecting men and women equally and usually in the middle age. Serious airway manifestations occur in at least half of these patients. We present to you an interesting case report of a 20-year-old female who presented with exertional breathlessness. Imaging revealed diffuse calcification of pinna and tracheobronchial tree. Based on the characteristic clinical features and imaging studies a diagnosis of relapsing polychondritis was attained.
Collapse
Affiliation(s)
- Shibani V Anchan
- Assistant Professor, Department of Ear, Nose and Throat, SDM College of Medical Sciences and Hospital , Dharwad, Karnataka, India
| | - Santosh S Garag
- Assistant Professor, Department of Ear, Nose and Throat, SDM College of Medical Sciences and Hospital , Dharwad, Karnataka, India
| | - Arunkumar J S
- Professor, Department of Ear, Nose and Throat, SDM College of Medical Sciences and Hospital , Dharwad, Karnataka, India
| | - K C Prasad
- Professor, Department of Ear, Nose and Throat, SDM College of Medical Sciences and Hospital , Dharwad, Karnataka, India
| | - Poorvi V Sharma
- Postgraduate, Department of Ear, Nose and Throat, SDM College of Medical Sciences and Hospital , Dharwad, Karnataka, India
| |
Collapse
|
11
|
Al Ameri O, Chaouat M, Marco O, Azoulay B, Hersant B, Mimoun M. [Major chest wall resection for the treatment of invasive breast carcinoma: A series of 33 patients]. ANN CHIR PLAST ESTH 2013; 59:115-22. [PMID: 24230974 DOI: 10.1016/j.anplas.2013.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 10/13/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Breast cancer can spread to the chest wall. It is an aggressive stage of poor prognosis. We have developed a technique of major chest wall resection extended beyond the breast area in order to reduce the recurrence. PATIENTS AND METHODS This is a retrospective single-center series of 33 patients with breast cancer spread to the chest wall without metastasis (13 patients present with primary breast cancer and 20 patients present with recurrent breast cancer) treated by major chest wall resection between January 1993 and January 2013, by the same surgeon. Analysis of the results was made by another surgeon. RESULTS Patients aged between 27-83years with an average of 55years. The removed parts measured 350cm(2) to 1200cm(2), and the average duration of complete healing was 7.9months. The mean follow-up time was 122months (6months-240months). The 1 year survival was 84.4%, at 2years 72.6%, at 3years 69.5% and at 5 years of 66.4%. CONCLUSION The technique of major chest wall resection is simple and reproducible. Breast cancer with chest wall extension has a poor prognosis. At the end of the study, 20 of 33 patients who benefit from this technique are still alive.
Collapse
Affiliation(s)
- O Al Ameri
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - M Chaouat
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - O Marco
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - B Azoulay
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - B Hersant
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| | - M Mimoun
- Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris cedex 10, France.
| |
Collapse
|
12
|
Bellon N, Anguel N, Vandendries C, Goujard C, Lambotte O. Auricular chondritis and thrombotic microangiopathy: an unusual combination revealing systemic lupus erythematosus. Joint Bone Spine 2013; 80:424-5. [PMID: 23332392 DOI: 10.1016/j.jbspin.2012.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 11/19/2012] [Indexed: 11/28/2022]
Abstract
Thrombotic microangiopathy is a severe disorder, which is a cause of stroke in young patients. Etiologic investigations are mandatory to diagnose underlying disease. Systemic lupus erythematosus is one of the diseases, which can be associated with thrombotic microangiopathy. Although lupus diagnosis is usually easy, relying on characteristic clinical manifestations, rare symptoms can be misinterpreted. We report here a case of polychondritis, which was the first manifestation of a lupus-associated thrombotic microangiopathy.
Collapse
Affiliation(s)
- Nathalia Bellon
- AP-HP, Department of Internal Medicine, Bicêtre University Medical Center, 78, rue du Général-Leclerc, 94275 Le-Kremlin-Bicêtre, France
| | | | | | | | | |
Collapse
|