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Relapsing Polychondritis

David E. Trentham, MD; and Christine H. Le, MBBS, FRACP
[+] Article and Author Information

From Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts. Grant Support: In part by the Relapsing Polychondritis and Rheumatoid Arthritis Research Endowment Fund at Beth Israel Deaconess Medical Center. Requests for Reprints: David E. Trentham, MD, Division of Rheumatology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215. Current Author Addresses: Drs. Trentham and Le: Division of Rheumatology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1998;129(2):114-122. doi:10.7326/0003-4819-129-2-199807150-00011
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Relapsing polychondritis, an uncommon, chronic, multisystem disorder characterized by recurrent episodes of inflammation of cartilaginous tissues, can be life-threatening, debilitating, and difficult to diagnose. This review is based on the authors' experience with 36 patients with relapsing polychondritis who were followed from 1980 to 1997, 30 patients located elsewhere who completed a detailed questionnaire and interview, and a perusal of English-language textbooks and papers located by a systematic search of the MEDLINE database. Relapsing polychondritis can present in a highly ambiguous fashion; therefore, in the authors' series, the mean delay from the time medical attention was sought because of symptom onset until diagnosis was 2.9 years. Although prednisone was the main form of treatment, methotrexate seemed to be of additional value. Survival was much more favorable than previously thought. Greater awareness of relapsing polychondritis would probably lead to earlier diagnosis and better outcomes.

Figures

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Figure 1.
Inflammation of the ear in relapsing polychondritis.

The inferior soft lobule, which lacks cartilage, is spared.

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Figure 2.
Episcleritis caused by relapsing polychondritis.
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Grahic Jump Location
Figure 3.
Collapse of the cartilaginous nasal septum in relapsing polychondritis.

The bony nasal septum has remained intact, and the patient has a hairstyle that diminishes the cosmetic sequelae of this disease.

Grahic Jump Location

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