Clinical Characteristics of Our Follow-Up Patients with the Rare Disease Relapsing Polychondritis: A Single-Center Study

B. Yağız, B. N. Coşkun, S. Çelik, Y. Pehlivan, H. E. Dalkılıç
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Abstract

Relapsing polychondritis (RP) is an immune-mediated, systemic inflammatory and degenerative disease that affects cartilaginous structures particularly the ears, nose, eyes, joints, and respiratory tract and other tissues in the body. RP targets non-cartilaginous structures such as skin, kidney, heart, and the central nervous system in addition to cartilage-containing structures. Since it is a rare disease, data on its epidemiology are insufficient. It is prevalent between the ages of 40 and 60. Men and women are affected equally. Clinical characteristics vary among patients. The disease's rarity and broad clinical spectrum frequently result in misdiagnosis or delayed diagnosis. To prevent related complications and death, and to improve prognosis, early diagnosis and timely treatment of RP are crucial. Glucocorticoids, dapsone, disease-modifying antirheumatic drugs (DMARDs), and biologics are available as treatment options. The prognosis, such as the clinical presentation, varies depending on the extent of organ damage. 10 patients with RP had a mean onset age of 49.5±4.1. The median time between symptom onset and diagnosis was 3 months (2-60). 80% of the patients were male. The most frequent clinical manifestation is auricular chondritis (100%). During treatment, oral prednisolone was administered to all patients at least once. Intravenous methylprednisolone was administered to two patients. Due to ineffectiveness of DMARDs, one patient was switched to infliximab. A patient died due to pneumosepsis. This article aims to increase clinicians' awareness of this rare disease that can affect multiple systems by providing an overview of its pathogenesis, clinical course, diagnosis, and treatment.
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罕见疾病复发性多软骨炎随访患者的临床特征:一项单中心研究
复发性多软骨炎(RP)是一种免疫介导的全身性炎症性退行性疾病,主要影响软骨结构,特别是耳、鼻、眼、关节、呼吸道和身体其他组织。除了含软骨结构外,RP还针对非软骨结构,如皮肤、肾脏、心脏和中枢神经系统。由于这是一种罕见的疾病,有关其流行病学的数据不足。它在40到60岁之间普遍存在。男性和女性同样受到影响。患者的临床特征各不相同。该病的罕见性和广泛的临床频谱经常导致误诊或延误诊断。早期诊断和及时治疗对于预防RP相关并发症和死亡,改善预后至关重要。糖皮质激素、氨苯砜、改善疾病的抗风湿药物(DMARDs)和生物制剂都是可用的治疗选择。预后,如临床表现,取决于器官损害的程度。10例RP患者平均发病年龄49.5±4.1岁。从症状出现到诊断的中位时间为3个月(2-60)。80%的患者为男性。最常见的临床表现为耳廓软骨炎(100%)。在治疗期间,所有患者至少口服强的松龙一次。2例患者静脉注射甲基强的松龙。由于DMARDs无效,一名患者改用英夫利昔单抗。一个病人死于肺炎败血症。本文旨在通过概述其发病机制、临床病程、诊断和治疗,提高临床医生对这种可影响多个系统的罕见疾病的认识。
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