Relapsing Polychondritis (cont.)
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 to the doctor.
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, 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 patient 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, and combinations of these drugs with steroids.
Next: What is the long-term outlook (prognosis) for patients with
relapsing polychondritis? »
- Nonsteroidal Antiinflammatory Drugs (NSAIDs) - Describes Nonsteroidal Antiinflammatory Drugs (NSAIDs), which are medications used primarily to treat inflammation, mild to moderate pain, and fever.
- Sedimentation Rate - Learn more about sedimentation rate, including a description of the test, how it is performed, and normal rate measurements.
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
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