Fraisse T, Brunel A-S, Arnaud E, Balducchi J-P, Jourdan J, de Wazières B, Sotto A
Service des maladies infectieuses et tropicales, groupe hospitalo-universitaire Caremeau, Nîmes cedex 9, France.
Rev Med Interne. 2008 Oct;29(10):801-4. doi: 10.1016/j.revmed.2008.03.370. Epub 2008 May 19.
The diagnosis of relapsing polychondritis is difficult as various manifestations may be encountered aside the characteristic episodes of recurrent chondritis.
From the retrospective analysis of the medical charts of patients presenting with relapsing polychondritis seen at Nîmes hospital between 1995 to 2006, four were selected for their original extra-cartilaginous manifestations. Case 1: relapsing polychondritis was diagnosed at the time of a thromboembolic event associated with a right uveitis, left temporomandibular arthritis and bilateral sensorineural deafness. Case 2: relapsing polychondritis occurred in a patient with history of bilateral sensorineural deafness with punctuated keratitis followed by a relapsing cutaneous leucocytoclastic vasculitis. Case 3: relapsing polychondritis associated with recurrent thromboembolic disease and a Sweet's syndrome and case 4: relapsing polychondritis presenting with a febrile erythema.
The reported observations highlight the difficulty of the initial diagnosis of relapsing chondritis and the variety of the extra-chondritis manifestations that could be observed in this disease.
复发性多软骨炎的诊断较为困难,因为除了复发性软骨炎的典型发作外,还可能出现各种表现。
通过对1995年至2006年在尼姆医院就诊的复发性多软骨炎患者病历进行回顾性分析,选择了4例具有原始软骨外表现的患者。病例1:在与右眼葡萄膜炎、左颞下颌关节炎和双侧感音神经性耳聋相关的血栓栓塞事件时诊断为复发性多软骨炎。病例2:复发性多软骨炎发生在一名有双侧感音神经性耳聋病史、点状角膜炎,随后出现复发性皮肤白细胞破碎性血管炎的患者身上。病例3:复发性多软骨炎与复发性血栓栓塞性疾病和Sweet综合征相关,病例4:复发性多软骨炎表现为发热性红斑。
所报告的观察结果突出了复发性软骨炎初始诊断的困难以及该疾病中可观察到的软骨外表现的多样性。