Relapsing polychondritis: Difference between revisions
No edit summary |
|||
Line 59: | Line 59: | ||
===Laboratory Findings=== | ===Laboratory Findings=== | ||
*There are no specific laboratory findings associated with relapsing polychondritis. | |||
*Abnormal laboratory findings consistent with the diagnosis of relapsing polychondritis include: | |||
**CBC with differentials | |||
***Low hemoglobin | |||
***Leukocytosis | |||
***Eosinophilia | |||
**ESR and CRP are usually raised | |||
**Antibody testing | |||
***Anti-type II collagen antibodies is usually raised in early phase of disease<ref name="pmid714080">{{cite journal |vauthors=Foidart JM, Abe S, Martin GR, Zizic TM, Barnett EV, Lawley TJ, Katz SI |title=Antibodies to type II collagen in relapsing polychondritis |journal=N. Engl. J. Med. |volume=299 |issue=22 |pages=1203–7 |date=November 1978 |pmid=714080 |doi=10.1056/NEJM197811302992202 |url=}}</ref><ref name="pmid7030234">{{cite journal |vauthors=Ebringer R, Rook G, Swana GT, Bottazzo GF, Doniach D |title=Autoantibodies to cartilage and type II collagen in relapsing polychondritis and other rheumatic diseases |journal=Ann. Rheum. Dis. |volume=40 |issue=5 |pages=473–9 |date=October 1981 |pmid=7030234 |pmc=1000784 |doi= |url=}}</ref> | |||
***Antineutrophil cytoplasmic antibodies is found in patients who has vasculitis<ref name="pmid8323388">{{cite journal |vauthors=Papo T, Piette JC, Le Thi Huong Du, Godeau P, Meyer O, Kahn MF, Bourgeois P |title=Antineutrophil cytoplasmic antibodies in polychondritis |journal=Ann. Rheum. Dis. |volume=52 |issue=5 |pages=384–5 |date=May 1993 |pmid=8323388 |pmc=1005055 |doi= |url=}}</ref> | |||
===Imaging Findings=== | ===Imaging Findings=== | ||
===Other Diagnostic Studies=== | ===Other Diagnostic Studies=== |
Revision as of 16:05, 27 April 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ,Associate Editor(s)-in-Chief: Soumya Sachdeva
Overview
Relapsing polychondritis is a condition where cartilage deteriorates.
It is also known as Chronic atrophic polychondritis, Meyenburg-Altherr-Uehlinger syndrome, von Meyenburg's disease, Generalized chondromalacia, or Systemic chondromalacia.
Historical Perspective
Classification
Polychondritis is one of many subclasses of disease in the area of Rheumatology.
Pathophysiology
The earliest abnormality of hyaline and elastic cartilage noted histologically is basophilic staining indicating depletion of proteoglycan from the cartilage matrix. Inflammatory infiltrates are found adjacent to involved cartilage and consist predominantly of mononuclear cells and occasional plasma. Immunologic mechanisms play an important role in the pathogenesis of relapsing polychondritis.Humoral and cell mediated immunity play an important role in the pathogenesis.Immunoglobin and complement deposits are found at sites of inflammation.
Causes
Reasons for disease onset are not known.
It is considered to possibly be an auto-immune disease[1] in which the human's body's immune system begins to attack and destroy the cartilage tissues in the body.
Differentiating Relapsing Polychondritis from other Diseases
- Cauliflower ear
- Chondritis
- Chondromdermatitis
- Hansen's disease
- Nodularis helicis
- Perichondritis
- Rhinophyma
- Skin cancer
- Syphilis
Epidemiology and Demographics
Age
- While the disease can come on at various times, most frequent time for onset is in the late 40's to early 50's.
Gender
- Some literature reports a slightly higher occurrence in females than males, while other literature asserts that sex is apparently not a statistically significant factor in the occurrence rate of the disease.
Race
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Symptoms
- Decreased joint mobility
- Joint erythema
- Joint inflammation
- Joint swelling
- Pain on movement of joint
Physical Examination
All cartilage areas can be affected, though in many cases the disease will affect several areas where cartilage is found in the body, and leave others entirely alone. Parts of the body with cartilage, and therefore potentially affected by polychondritis, include the ears, nose, throat, heart valves and of course all areas where musculo-skeletal tissues are connected by cartilage. Specific resultant conditions may include Type 3 Tracheomalacia and Vasculitis.
Laboratory Findings
- There are no specific laboratory findings associated with relapsing polychondritis.
- Abnormal laboratory findings consistent with the diagnosis of relapsing polychondritis include:
Imaging Findings
Other Diagnostic Studies
Presentation
Symptoms
Treatment
Medical Therapy
Treatment plans typically involve suppression of the immune system with medicines, which often result in a side effect of increasing the risk of other infections.
Surgery
Prevention
References
- ↑ "Relapsing Polychondritis: Autoimmune Disorders of Connective Tissue: Merck Manual Home Edition".
- ↑ Foidart JM, Abe S, Martin GR, Zizic TM, Barnett EV, Lawley TJ, Katz SI (November 1978). "Antibodies to type II collagen in relapsing polychondritis". N. Engl. J. Med. 299 (22): 1203–7. doi:10.1056/NEJM197811302992202. PMID 714080.
- ↑ Ebringer R, Rook G, Swana GT, Bottazzo GF, Doniach D (October 1981). "Autoantibodies to cartilage and type II collagen in relapsing polychondritis and other rheumatic diseases". Ann. Rheum. Dis. 40 (5): 473–9. PMC 1000784. PMID 7030234.
- ↑ Papo T, Piette JC, Le Thi Huong D, Godeau P, Meyer O, Kahn MF, Bourgeois P (May 1993). "Antineutrophil cytoplasmic antibodies in polychondritis". Ann. Rheum. Dis. 52 (5): 384–5. PMC 1005055. PMID 8323388. Vancouver style error: initials (help)
External links
- Polychondritis Educational Society, Ltd. (PES)
- Dr. D. E. Trentham research paper
- MedicineNet.com
- The Polychondritis Group - Support Group
Template:Osteochondropathy
Template:Diseases of the musculoskeletal system and connective tissue