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复发性多软骨炎:罕见病中的“变色龙”。

Relapsing polychondritis: a chameleon among orphan diseases.

作者信息

Schumacher Sabine, Pieringer Herwig

机构信息

Academic Research Unit, 2nd Department of Medicine, Kepler University Hospital Linz, Krankenhausstraße 9, 4020, Linz, Austria.

Paracelsus Private Medical University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.

出版信息

Wien Med Wochenschr. 2017 Jun;167(9-10):227-233. doi: 10.1007/s10354-017-0559-1. Epub 2017 Mar 31.

Abstract

Relapsing polychondritis (RPC) is a rare disease with recurrent episodes of inflammation of cartilage tissue leading to fibrosis and organ damage. Despite unknown etiology, there is some evidence of a genetic predisposition. The clinical presentation is heterogeneous and an association with other autoimmune disorders such as rheumatoid arthritis or different forms of vasculitis has been described. All organ systems containing cartilage can be affected, such as ear, nose, joints, trachea, aorta, and coronary arteries. Given the broad spectrum of potential manifestations, a variety of medical specialists may be involved in the management of RPC patients. As establishing the diagnosis of RPC may be difficult, an interdisciplinary approach may be preferable. Treatment options include glucocorticoids, dapsone, disease-modifying antirheumatic drugs, and biologics. Prognosis is as heterogeneous as the clinical picture, depending on the severity of organ damage. In this paper we give an overview of the current knowledge with regard to pathogenesis, clinical picture, diagnosis, and therapy of RPC.

摘要

复发性多软骨炎(RPC)是一种罕见疾病,软骨组织反复发生炎症,导致纤维化和器官损害。尽管病因不明,但有一些遗传易感性的证据。临床表现具有异质性,并且已描述其与其他自身免疫性疾病如类风湿性关节炎或不同形式的血管炎有关。所有含有软骨的器官系统都可能受到影响,如耳、鼻、关节、气管、主动脉和冠状动脉。鉴于潜在表现的范围广泛,多种医学专家可能参与RPC患者的管理。由于确立RPC的诊断可能困难,采用跨学科方法可能更为可取。治疗选择包括糖皮质激素、氨苯砜、改善病情的抗风湿药物和生物制剂。预后与临床表现一样具有异质性,取决于器官损害的严重程度。在本文中,我们概述了目前关于RPC发病机制、临床表现、诊断和治疗的知识。

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