Damiani J M, Levine H L
Laryngoscope. 1979 Jun;89(6 Pt 1):929-46.
Relapsing polychondritis is a rare disease of unknown etiology. There are approximately 211 reported cases in the world literature. This is a report of ten cases from the Cleveland Clinic Foundation. McAdam's diagnostic criteria for R.P. were reviewed and modified. For diagnosis, all patients had to have 1. at least three or more diagnostic criteria, histologic confirmation not necessary; 2. one or more of McAdam's signs with positive histologic confirmation; or 3. chondritis in two or more separate anatomic locations with response to steroids and/or Dapsone. Chondritis of the auricles (9/10 patients) and arthropathy (8/10 patients) are the most common presenting signs. Chondritis was also seen in the nose (6/10) and the upper respiratory tract involving the larynx and trachea (4/10). Cochlear and vestibular damage and ocular inflammation were each seen in 5/10 patients. Patients were treated with steroids and/or Dapsone. Both drugs were reliable in abating episodes of activity and in decreasing recurrences. These results further support Dapsone as an alternate form of treatment for RP.
复发性多软骨炎是一种病因不明的罕见疾病。世界文献中报道的病例约有211例。本文报告了克利夫兰诊所基金会的10例病例。对麦克亚当(McAdam)关于复发性多软骨炎的诊断标准进行了回顾和修订。对于诊断,所有患者必须满足以下条件之一:1. 至少有三条或更多诊断标准,无需组织学证实;2. 有一条或多条麦克亚当体征且组织学证实为阳性;或3. 两个或更多不同解剖部位的软骨炎对类固醇和/或氨苯砜有反应。耳廓软骨炎(9/10患者)和关节病(8/10患者)是最常见的首发症状。鼻软骨炎(6/10)以及累及喉和气管的上呼吸道软骨炎(4/10)也可见到。耳蜗和前庭损伤以及眼部炎症在5/10患者中均有出现。患者接受了类固醇和/或氨苯砜治疗。这两种药物在减轻活动发作和减少复发方面都很可靠。这些结果进一步支持氨苯砜作为复发性多软骨炎的一种替代治疗形式。