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
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.
Lakhder Amine Betaimi,
Djamel Eddine Benkali,
Replasing Polychondritis and Geriatrics: Report of Two Cases, American Journal of Internal Medicine.
Vol. 6, No. 2,
2018, pp. 29-33.
Nisha Hazraet al.Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study; Rheumatology 2015;54:2181-2187.
Rovenský J, Sedláčková M (2016) Relapsing Polychondritis. J Rheum Dis Treat 2:043.
H. Rhys Davies and A.R.Kelsall. Atrophic polychondritis with the report of a case;Ann. rheum. Dis. (1961), 20, 189.
Beata Sosada, KatarzynaLoza, and EwelinaBialo-Wojcicka. Relapsing Polychondritis.Case Reports in Dermatological Medicine Volume 2014, Article ID 791951,4 pages.
Mathian A, et al., Relapsing polychondritis: A 2016 update on clinical features, diagnostic tools, treatment and biological drug use, Best Practice &Research Clinical Rheumatology (2016).
L. Cantarini et al. / Journal of Autoimmunity 48-49 (2014) 53-59.
Dion J, et al Relapsing polychondritis: What’snewin2017?; Rev Med Interne(2017); [Article in French].
Abdul Latif Hamdan, DojaSarieddine. Larngeal Manifestations ofRelapsingPolychondritis; Open Journal of Rheumatology and Autoimmune Diseases, 2013, 3, 108-112.
T. Lahmer et al. Relapsing polychondritis: An autoimmune disease with many faces;Autoimmunity Reviews 9 (2010) 540–546.
Puéchal X, et al. Relapsing polychondritis. Joint Bone Spine (2014).
Longo L, et al, Relapsing polychondritis: A clinical update, Autoimmun Rev (2016).
Sabine Schumacher, Herwig Pieringer; Relapsing polychondritis: a chameleon among orphan diseases; Wien Med Wochenschr (2017).
Antonio Vitale, et al. Relapsing Polychondritis: an Update on Pathogenesis, Clinical Features, Diagnostic Tools, and Therapeutic Perspectives ;Curr Rheumatol Rep; (2015).
Letko et al. Relapsing Polychondritis: A Clinical Review; Seminars in Arthritis and Rheumatism, Vol 31, No 6 (June), 2002: pp 384-395.
Tyng Yu Chuah, Nai Lee Lui; Relapsing polychondritis in Singapore: a case series and review of literature; Singapore Med J 2017; 58(4): 201-205.
Emmungil and Aydın. Relapsing polychondritis; Eur J Rheumatol 2015; 4: 155-9.
JibahEng, FRCS, and Sabaratnam Sabanathan, FRCS. Airway Complications in Relapsing Polychondritis; Ann Thorac Surg 1991:51:686-92.
Bradley L,et al. Ocular and Systemic Findingsin Relapsing Polychondritis; Ophthalmology 93:681-689, 1986.
Drosos A. A. Relapsing Polychondritis; Orphanet encyclopedia, May 2004.
Miyasaka,LS, et al.Relapsing polychondritis Sao Paulo Medical Journal/RPM 116(1): 1637-1642, 1998.
Jérémie Dion et al. Relapsing polychondritis can be characterized by 3 different clinical phenotypes: Analysis of a recent series of 142 patients; Arthritis & Rheumatology (2016).
Raida BS, Yosra C, Faten F, Mouna S, Moez J, et al. (2016) A Relapsing Polychondritisand Malignancies: A Case Report and Review of Literature. J Dermatol Res Ther 2:04.
Le Besnerais M, Arnaud L, Bout´ emy J, Bienvenu B, L´ evesque H, Amoura Z, Marie I, Aortic involvement in relapsing polychondritis,Joint Bone Spine (2017).
Furuya et al; Relapsing polychondritis with different types ofocular inflammations; International Medical Case Reports Journal 2015:8 193–197.
Jun Shimizu, Hiroshi Oka, Yoshihisa Yamano, Kazuo Yudoh and Noboru Suzuki;Cardiac involvement in relapsing polychondritis in Japan, Rheumatology 2016; 55: 583584.
A-G A Selim, L G Fulford, R H Mohiaddin, M N Sheppard. Active aortitis in relapsing polychondritis; J Clin Pathol 2001; 54: 890–892.
Pablo Arturo Olivo Pallo, Maurício Levy-Neto, Rosa Maria Rodrigues Pereira, Samuel Katsuyuki Shinjo. Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender; rev bras reumatol. 2017; 57(4): 338–345.