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Harrison's Principles of Internal Medicine, 18e
| Part 15. Disorders of the Joints and Adjacent Tissues > Section 2. Disorders of Immune-Mediated Injury > |
Chapter 328. Relapsing Polychondritis
Sections: Relapsing Polychondritis: Introduction, Pathology and Pathophysiology, Clinical Manifestations, Laboratory Findings and Diagnostic Imaging, Diagnosis, Patient Outcome, Prognosis, and Survival, Acknowledgment, Further Readings.
Topics Discussed: polychondritis, relapsing.
Excerpt:"Relapsing polychondritis is an uncommon disorder of unknown cause characterized by inflammation of cartilage predominantly affecting the ears, nose, and laryngotracheobronchial tree. Other manifestations include scleritis, neurosensory hearing loss, polyarthritis, cardiac abnormalities, skin lesions, and glomerulonephritis. Relapsing polychondritis has been estimated to have an incidence of 3.5 per million population per year. The peak age of onset is between the ages of 40–50 years, but relapsing polychondritis may affect children and the elderly. It is found in all races, and both sexes are equally affected. No familial tendency is apparent. A significantly higher frequency of HLA-DR4 has been found in patients with relapsing polychondritis than in healthy individuals. A predominant subtype allele(s) of HLA-DR4 was not found. Approximately 30% of patients with relapsing polychondritis will have another rheumatologic disorder, the most frequent being systemic vasculitis, followed by rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjögren's syndrome, or the spondyloarthritides. Nonrheumatic disorders associated with relapsing polychondritis include inflammatory bowel disease, primary biliary cirrhosis, and myelodysplastic syndrome (Table 328-1). In most cases,..."
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