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- Relapsing polychondritis facts
- What is relapsing polychondritis?
- What causes relapsing polychondritis?
- What are symptoms and signs of relapsing polychondritis?
- How is relapsing polychondritis diagnosed?
- Can relapsing polychondritis be associated with other diseases?
- What medications are used to treat relapsing polychondritis?
- What is the long-term outlook (prognosis) for patients with relapsing polychondritis?
How is relapsing polychondritis diagnosed?
Relapsing polychondritis is diagnosed when the doctor recognizes the classic pattern of cartilage involvement during the history and physical examination. The symptoms described above can suggest the disease.
There is no one specific test for diagnosing relapsing polychondritis. Blood tests that indicate inflammation, such as an elevated erythrocyte sedimentation rate (ESR), C-reactive protein, and others, are often abnormal when the disease is active.
If tissue cartilage is biopsied, the involved cartilage will demonstrate nonspecific signs of inflammation.
Can relapsing polychondritis be associated with other diseases?
Yes. The doctor will be interested in determining whether or not signs of the following diseases are present along with relapsing polychondritis: vasculitis, Wegener's granulomatosis, systemic lupus erythematosus, ankylosing spondylitis, Reiter's disease, psoriatic arthritis, rheumatoid arthritis, Behcet's disease, Churg-Strauss syndrome, polyarteritis nodosa, myelodysplasia, and others.
What medications are used to treat relapsing polychondritis?
For patients with more mild disease, nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin), naproxen (Naprosyn), and others, can be helpful to control the inflammation. Usually, however, cortisone-related medications (steroids such as prednisone and prednisolone) are required. High-dose steroids are frequently necessary initially, especially when the eyes or breathing airways are involved. Moreover, most patients require steroids for long-term use.
Methotrexate (Rheumatrex, Trexall) has shown promise as a treatment for relapsing polychondritis in combination with steroids as well as a maintenance treatment. Studies have demonstrated that methotrexate can help reduce the steroid requirements.
Other medications that have been tried in small numbers of patients with some reports of success include cyclophosphamide (Cytoxan), dapsone, azathioprine (Imuran), penicillamine (Depen, Cuprimine), cyclosporine, anti-tumor necrosis factor (TNF) biologic medications (adalimumab [Humira], infliximab [Remicade]), and combinations of these drugs with steroids.