Azuma Naoto
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Nihon Rinsho Meneki Gakkai Kaishi. 2012;35(3):157-67. doi: 10.2177/jsci.35.157.
Relapsing Polychondritis (RP) is an uncommon, chronic, and potentially life-threatening multisystem disorder characterized by recurrent inflammatory episodes affecting the cartilaginous tissues of the external ears, nose, peripheral joints, larynx and tracheobronchial tree, sometimes leading to their destruction. RP can also inflame other proteoglycan-rich structures, such as the eye, heart, blood vessels and inner ears. Systemic symptoms are common, and vasculitis affecting skin or internal organs may occur. The etiology of RP is still unknown, but the pathogenetic role of the autoimmunity is suggested by frequent overlaps with various autoimmune diseases, and by the presence of autoantibody against cartilage in the serum of patients with RP. Although several reports have demonstrated the clinicopathologic manifestations and radiologic findings of RP, there are no specific features of RP. Therefore, it is difficult to show the diagnosis of RP. Airway involvements are major causes of morbidity and mortality, and they have accounted for most of the deaths due to RP. To suppress the inflammation of airway mucosa and cartilage is extremely important in the successful treatment for RP. Above all, earlier diagnosis would lead to better outcomes.
复发性多软骨炎(RP)是一种罕见的、慢性的且可能危及生命的多系统疾病,其特征为反复发作的炎症,累及外耳、鼻、外周关节、喉及气管支气管树的软骨组织,有时会导致这些组织遭到破坏。RP还可使其他富含蛋白聚糖的结构发生炎症,如眼、心脏、血管及内耳。全身症状较为常见,可能会出现累及皮肤或内脏器官的血管炎。RP的病因仍不明确,但自身免疫的致病作用可由其与多种自身免疫性疾病频繁重叠以及RP患者血清中存在抗软骨自身抗体推测得出。尽管已有多篇报道阐述了RP的临床病理表现及影像学特征,但RP并无特异性表现。因此,RP的诊断较为困难。气道受累是发病和死亡的主要原因,且在RP导致的死亡中占大多数。抑制气道黏膜及软骨的炎症对于RP的成功治疗极为重要。最重要的是,早期诊断会带来更好的治疗效果。