Shimizu Jun, Oka Hiroshi, Yamano Yoshihisa, Yudoh Kazuo, Suzuki Noboru
Institute of Medical Science and Departments of Immunology and Medicine, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan.
Rheumatic Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, 193-0998, Japan.
Clin Rheumatol. 2016 Mar;35(3):781-3. doi: 10.1007/s10067-015-3160-2. Epub 2016 Jan 16.
The aim of this study was to determine the prognostic characteristics of patients with relapsing polychondritis (RP) accompanying cutaneous manifestations in Japan. We analyzed a cohort of 239 patients with RP in view of cutaneous and extracutaneous complications. Thirty three cases (14%) developed cutaneous manifestations and 23 cases had both cutaneous and extracutaneous manifestations. Five RP patients developed myelodysplastic syndrome (MDS) and all of the five patients had cutaneous manifestations, including Sweet's syndrome. Only one patient died of MDS among the five patients, suggesting rather better prognosis as compared with ordinary MDS. Five RP patients developed Behcet's disease and all the five patients had cutaneous manifestations. Death rate of the RP patients with cutaneous manifestations (15%) was slightly higher than that of whole Japanese RP patient cohort (9.2%). RP patients with cutaneous manifestations had a slightly higher death rate, than those without cutaneous manifestations. MDS of RP patients had a rather better prognostic impact in Japan. Further studies are needed to elucidate the pathophysiology of RP, which brings about development of extracutaneous manifestations, especially MDS and Behcet's disease.
本研究的目的是确定日本复发性多软骨炎(RP)伴皮肤表现患者的预后特征。我们从皮肤和皮肤外并发症的角度分析了一组239例RP患者。33例(14%)出现皮肤表现,23例同时有皮肤和皮肤外表现。5例RP患者发生骨髓增生异常综合征(MDS),这5例患者均有皮肤表现,包括Sweet综合征。这5例患者中仅1例死于MDS,提示与普通MDS相比预后较好。5例RP患者发生白塞病,这5例患者均有皮肤表现。有皮肤表现的RP患者死亡率(15%)略高于日本RP患者总队列(9.2%)。有皮肤表现的RP患者死亡率略高于无皮肤表现的患者。在日本,RP患者的MDS预后影响较好。需要进一步研究以阐明导致皮肤外表现尤其是MDS和白塞病发生的RP的病理生理学。