🔹Relapsing Polychondritis🔹
Important takeaways from an excellent presentation by @Lupusreference @eular_org #EULAR2023
#MedTwitter #RheumTwitter
Important takeaways from an excellent presentation by @Lupusreference @eular_org #EULAR2023
#MedTwitter #RheumTwitter
🔹Rare disease
🔹Middle aged adults
🔹No♀️ predominance
👂👂👂👂
It's typically characterized by:
🥵Red/swollen
👂Spares the lobule
🤕Painful
⏳lasts >48 hrs
❌ ear discharge (infection)
❌ necrosis/purpura (CAPS)
📷⤵️Prone to erroneous diagnosis!!
🔹Middle aged adults
🔹No♀️ predominance
👂👂👂👂
It's typically characterized by:
🥵Red/swollen
👂Spares the lobule
🤕Painful
⏳lasts >48 hrs
❌ ear discharge (infection)
❌ necrosis/purpura (CAPS)
📷⤵️Prone to erroneous diagnosis!!
Once 👂chondritis is confirmed, rule out mimics!
👃👃👃👃
Nasal chondritis
🔹Pain at the root of the nose, but no local inflammation can be seen
Nasal chondritis
🔹Pain at the root of the nose, but no local inflammation can be seen
A good list of DDs again!
🫁🫁🫁🫁🫁
Respiratory Chondritis
🔹Larynx
Cervical pain
Dysphonia
Stridor
🔹Trachea
Cough
Chest pain
Respiratory failure
Respiratory Chondritis
🔹Larynx
Cervical pain
Dysphonia
Stridor
🔹Trachea
Cough
Chest pain
Respiratory failure
Remember, it begins with chondritis only in 60%!
Other features:
🔹🔥arthritis (relapsing, 🚫 erosive, seroneg, axial/peripheral)
🔹👁️: epi/scleritis
🔹Internal ear: vertigo/hearing loss
🔹🫀: aortitis, myocarditis (♂️, s/o VEXAS)
🔹Skin: neut dermatoses ( s/o VEXAS)
Other features:
🔹🔥arthritis (relapsing, 🚫 erosive, seroneg, axial/peripheral)
🔹👁️: epi/scleritis
🔹Internal ear: vertigo/hearing loss
🔹🫀: aortitis, myocarditis (♂️, s/o VEXAS)
🔹Skin: neut dermatoses ( s/o VEXAS)
Can be classified into 3️⃣ clusters:
Relapsing Polychondritis vs VEXAS
Investigations fall into three domains:
🔹Confirm diagnosis and rule out mimics
🔹Extent of disease
🔹Rule out an associated disease
🔹Confirm diagnosis and rule out mimics
🔹Extent of disease
🔹Rule out an associated disease
How do we treat??
No RCTs
🔹1st episode of minor chondritis: NSAIDs, short steroids (taper & stop over 10 dyas)
🔹Relapsing: colchicine ⏩ methotrexate/dapsone
🔹Severe organ manifestations: high dose steroids + Cyclophosphamide
No RCTs
🔹1st episode of minor chondritis: NSAIDs, short steroids (taper & stop over 10 dyas)
🔹Relapsing: colchicine ⏩ methotrexate/dapsone
🔹Severe organ manifestations: high dose steroids + Cyclophosphamide
• • •
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