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Published on: May 16, 2025
[Diagnosis and treatment of relapsing polychondritis]
Ke-Jian Xu1, Yue-Hua Liu, Ming Jiang
1Department of Dermatology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Summary
Relapsing polychondritis (RP) affects cartilage and connective tissue, with severe airway complications. Treatment with corticosteroids and immunosuppressants, alongside airway stenting for stenosis, effectively manages symptoms.
Area of Science:
- Rheumatology
- Immunology
- Otolaryngology
Context:
- Relapsing polychondritis (RP) is a rare, episodic inflammatory condition affecting cartilage and connective tissues.
- Laryngotracheobronchial involvement represents a severe manifestation of RP, potentially leading to life-threatening airway obstruction.
Purpose:
- To retrospectively analyze the clinical manifestations, diagnostic methods, and treatment outcomes of 24 patients diagnosed with relapsing polychondritis.
- To evaluate the efficacy of current therapeutic strategies, including immunosuppressants and airway interventions, for managing RP.
Summary:
- Analysis of 24 RP patients revealed autoimmune antibodies in some cases (ANA, SSA, RNP, Sm).
- Laryngoscopy and bronchoscopy identified significant airway pathology, including edema, stenosis, and cartilage destruction.
- Histopathology confirmed chronic inflammation of cartilage. Treatment with corticosteroids and immunosuppressants (cyclophosphamide, methotrexate) resulted in symptom alleviation in 23 out of 24 patients. Airway interventions like laryngotracheostomy or stenting were crucial for managing respiratory complications.
Impact:
- This study highlights the critical role of early diagnosis and aggressive management of laryngotracheobronchial complications in relapsing polychondritis.
- Effective treatment strategies involving corticosteroids, immunosuppressants, and surgical airway support can significantly improve patient outcomes and reduce mortality.
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