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Relapsing Polychondritis Case Presentaion Feb 2009 DR - Bugnah
Relapsing Polychondritis Case Presentaion Feb 2009 DR - Bugnah
RELAPSING
POLYCHONDRITIS
Dr.Sherif Bugnah, supervised by Dr.Muslih
Relapsing Polychondritis
Case Presentation
Relapsing Polychondritis
Case Presentation
CASE – Workup CBC : abnormal results (WBS, RDW (ESR),
PLTS, HG..)
CASE – Workup UE/LFT (Normal levels)
CASE – Workup Serology
CASE - MANGEMENT
4th day
•Steroid Injections given
dramatic improvement for all symptoms
•Rheumatologist Consulted
Diagnosed case as Relapsing Polychondritis
Started Methotrexate (Cytotoxic Therapy) +
Steroids (Prednisolone)
Unknown
Autoimmune?
Humeral - AutoAb to
collagen type II, IX, XI
(30-70%)
Ag-Ab complexes,
Prednisone titers
Cellular - infiltrating
lymphocytes &
neutrophils
Relapsing Polychondritis
Diagnosis
Clinical Diagnosis:
supported by
laboratory data,
imaging procedures,
and biopsy of an
involved
cartilaginous site
Targets of Relapsing Polychondritis
Cartilage
Ear & Nose (Elastic)
Trachea/bronchus
Joints (hyaline)
Other Systems
Inner ear
Eyes
Heart
Blood vessels
Kidneys
Relapsing Polychondritis
Diagnostic Criteria (old)
Diagnostic criteria for RP were Newer Criteria* (1 of 3
proposed by McAdam. (3 of 6) conditions is met)
2. Auricular Chondritis Three McAdam criteria
3. Nonerosive Seronegative One McAdam criterion plus
Inflammatory Polyarthritis positive histology
4. Nasal Chondritis Two McAdam criteria plus
5. Ocular inflammation therapeutic response to
corticosteroid or dapsone
6. Respiratory Tract Chondritis administration
7. Audiovestibular Damage *Damiani and Levine
LAB WORKUP : Relapsing Polychondritis
Computed Tomography (Rapid Cut Insp/Exp)
18
Laryngo
tracheal
bronchial
wall
thickening
, luminal
narrowing
, and
cartilagin
ous
calcificati
Relapsing Polychondritis
THE COMPLETE WORKUP
19
THANK YOU