Replasing Polychondritis and Geriatrics: Report of Two Cases
American Journal of Internal Medicine
Volume 6, Issue 2, March 2018, Pages: 29-33
Received: Mar. 5, 2018; Accepted: Apr. 2, 2018; Published: May 17, 2018
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Nassima Dekdouk, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
Djennette Hakem, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
Lakhder Amine Betaimi, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
Djamel Eddine Benkali, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
Taous Hadded, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
Abdelkrim Berrah, Department of Internal Medicine, Faculty of Medicine, Benyoucef Benkhedda University, Algiers, Algeria
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We report two cases of geriatric replasing polychondritis [RP] observed in internal medicine; and the problems posed by the therapeutic management of this condition at this phase vulnerable of life. The first case was a70- years old women without antecedents, presents a diffuse and painful and bilateral increase of both ears, and painful red eyes with blurring of vision. The set of disorders evolves in a context of fever and deterioration of the general state and poly arthralgia of mixed schedule.The objective clinical examination finded a deformed ears ‘Cauliflower ear’; and a breath of aortic insufficiency in cardiac auscualtation; and bilateral episcleritis in the tow eyes objective in ophtalmic examination; associated with a biological inflammatory syndrome; the echocardiography objective, the moderate aortic regurgitation.The second case was a67 year old male presented,with a history of pain and swelling of both ears lobes, with recurrent red left eye painless.He has a history of type 2 diabetes and hypertension, clinically he was noted to have a swollen exquisitely tender erythematous upper cartilaginous part of the right pinna with sparing of the earl obule,episcleritis in the left eye in a ophtalmologic examination associated a frank inflammatory syndrome, the echocardiography objective a mild oartic regurgitation.The diagnosis of RP is retained according to the criteria of michet et al in both patients.The 2 patients evolve favorably under corticotherapy instituted at a rate of 1mg / Kg / day.Corticotherapy treatment exposed the patient (case 1) to the appearance of osteoporosis with high risk of fracture and the appearance of controllable hypertension under treatment; and the patient (case 2) at imbalance of his hypertension and diabetes which led us to change his therapeutic arsenal to avoid metabolic and cardiovascular complications. The rarity of the disease and the variability of its clinical spectrum explain the lack of a therapeutic trial controlled and empirical nature of the therapeutic recommendations. Evolution is by pushing successive, whose frequency and severity are extremely variable. Complications Cardiovascular diseases are common and responsible for the death of one out of four patients, which clinician to screen them so as not to delay a sometimes difficult treatment.
Replasing Polychondrotisis, Geriatric, Comorbidities
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Nassima Dekdouk, Djennette Hakem, Lakhder Amine Betaimi, Djamel Eddine Benkali, Taous Hadded, Abdelkrim Berrah, Replasing Polychondritis and Geriatrics: Report of Two Cases, American Journal of Internal Medicine. Vol. 6, No. 2, 2018, pp. 29-33. doi: 10.11648/j.ajim.20180602.11
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