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Relapsing poly(peri)chondritis diagnosed by biopsy during inflammatory free interval: destructive polychondritis
C Jung1, J Müller-Höcker, G Rauh
1Medizinische Poliklinik, Ludwig-Maximilian-University, Munich, Germany.
Abstract:
Relapsing poly(peri)chondritis (RP) is a connective tissue disorder characterized by recurrent inflammatory episodes of cartilaginous structures and the involvement of special sense organs. The diagnostic criteria of McAdam 1976 include at least three of the following criteria: a) bilateral auricular chondritis, b) nonerosive sero-negative inflammatory polyarthritis, c) nasal chondritis, d) ocular inflammation, e) respiratory tract chondritis, f) audiovestibular chondritis. A cartilage biopsy according to these criteria is not mandatory. Nevertheless, unclear cases still remain as there is a broad spectrum of differential diagnosis. In these individuals it is important to obtain a biopsy from the affected cartilage. Although up to 89% develop auricular inflammation, only few electron microscope studies are performed on cartilage specimens. The purpose of this study is to report on a patient with a history of recurrent swelling of both ears, where the diagnosis could only be established by ear biopsy which was studied by light and electron microscopy. Differential diagnosis is discussed and a review of the literature is given.
Insights
Relapsing poly(peri)chondritis (RP) diagnosis can be confirmed by ear biopsy in unclear cases. This study highlights the diagnostic value of auricular cartilage examination in patients with suspected RP.
Area of Science:
- Rheumatology
- Pathology
- Oto-rhino-laryngology
Background:
- Relapsing poly(peri)chondritis (RP) is a rare connective tissue disorder affecting cartilaginous structures.
- Diagnostic criteria exist but can be challenging in atypical presentations.
- Auricular inflammation is common, yet cartilage biopsy is infrequently utilized.
Observation:
- A patient presented with recurrent ear swelling, prompting diagnostic investigation.
- Standard diagnostic criteria were insufficient for a definitive diagnosis.
- Ear biopsy provided crucial histopathological evidence.
Findings:
- Light and electron microscopy of the auricular biopsy revealed characteristic changes of RP.
- The biopsy confirmed the diagnosis in a clinically ambiguous case.
- This underscores the utility of cartilage biopsy in RP diagnosis.
Implications:
- Ear biopsy can be a valuable tool for diagnosing relapsing poly(peri)chondritis, especially in complex cases.
- Histopathological examination of cartilage aids in differentiating RP from other conditions.
- Further research into the role of cartilage biopsy in RP diagnosis is warranted.