Relapsing polychondritis: A clinical review*
Section snippets
Methods
A detailed search of literature published between January 1966 and November 2001 via MEDLINE (PubMed) was performed using relapsing polychondritis as the key word. Relevant articles published in peer-reviewed journals were analyzed. These articles focused on history, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of RP. The ocular manifestations of RP were emphasized.
Epidemiology
Relapsing polychondritis is rare. Luthra (10) estimated the annual incidence as 3.5 cases per million in Rochester, NY. More than 600 cases have been reported worldwide. The average age at the time of diagnosis is 44 to 51 years (11), but may appear as early as 5 and as late as 84 years of age (12). The male-to-female ratio has been estimated to be between 1:1 and 1:3 (11).
A single congenital case, in which a pregnant woman with RP gave birth to a child with tender red knees and a saddle nose,
Etiology and pathogenesis
The etiology of RP is unknown, but the pathogenesis seems to be an immunologic reaction to type II collagen. Type II collagen is present in the sclera of the eye and in cartilage. Patients with RP have demonstrated both autoantibodies and cellular immune reactions to type II collagen 15, 16, 17, 18.
Cellular immune reaction has been described against cartilage extracts by means of lymphocyte transformation or macrophage migration inhibition methods (18). Foidart et al (17) and Giroux et al (19)
References (91)
- et al.
Relapsing polychondritis analytical review and studies on pathogenesis
Am J Med
(1966) - et al.
Relapsing polychondritis: An autoimmune disease
Semin Arthritis Rheum
(1983) - et al.
Study of differential collagen synthesis during development of a chick embryo by immunofluorescence. I. Preparation of collagen type I and type II specific antibodies and their application to early stages of the chick embryo
Dev Biol
(1976) - et al.
Ocular and systemic findings in relapsing polychondritis
Ophthalmology
(1986) - et al.
Pulmonary function in patients with relapsing polychondritis
Chest
(1982) - et al.
Relapsing polychondritis: Review of current status and case report
Semin Arthritis Rheum
(1975) - et al.
Cardiovascular involvement in relapsing polychondritis
Semin Arthritis Rheum
(1997) - et al.
Multiple aortic aneurysms in relapsing polychondritis
Am J Cardiol
(1976) - et al.
Cardiac involvement in relapsing polychondritis
Int J Cardiol
(1987) - et al.
Mouth and genital ulcers with inflamed cartilage: MAGIC syndrome. Five patients with features of relapsing polychondritis and Behcet's disease
Am J Med
(1985)
Ocular lesions in relapsing polychondritis and other rheumatoid syndromes
Am J Ophthalmol
Relapsing polychondritis, rheumatoid arthritis and blindness
Am J Ophthalmol
Melting corneas with collapsing nose
Surv Ophthalmol
Anti-type II collagen ELISA. Increased disease specificity following removal of anionic contaminants from salt-fractionated type II collagen
J Immunol Methods
Scleritis in relapsing polychondritis
Ophthalmology
Chimeric anti-CD4 monoclonal antibody for relapsing polychondritis (letter)
Lancet
Immunosuppressive and corticosteroid therapy of polyarteritis nodosa
Am J Med
Relapsing polychondritis: Prospective study of 23 patients and a review of the literature
Medicine
Polychondropathia
Wien Arch Int Med
Uber eiven fall von systematisierter chondromalacia
Arch Pathol Anat
Uber chondromalacia
Schweiz Med Wochenschr
Diffuse perichondritis, chondritis, and iritis
Arch Ophthalmol
Relapsing polychondritis
N Engl J Med
Chronic atrophic polychondritis
Medicine
Relapsing polychondritis (diffuse chondrolysis)
Arch Dermatol
Pathology of the lung
Relapsing polychondritis
Ann Intern Med
Dermatologic manifestations of relapsing polychondritis: A study of 200 cases at a single center
Medicine
Familial chronic atrophic polychondritis
Arch Dermatol
Pregnancy in relapsing polychondritis
Arthritis Rheum
Autoantibodies to cartilage and type II collagen in relapsing polychondritis and other rheumatic diseases
Ann Rheum Dis
Antibodies to type II collagen in relapsing polychondritis
N Engl J Med
Involvement of nonarticular cartilage, as demonstrated by release of a cartilage-specific protein, in rheumatoid arthritis
Arthritis Rheum
Preferential cellular and humoral immune reactivities to native and denatured collagen types IX and XI in a patient with fatal relapsing polychondritis
J Rheumatol
Immunization against heterologous type II collagen induces arthritis in mice
Nature
Passive transfer by cells of type II collagen-induced arthritis in rats
J Clin Invest
Type II collagen-induced arthritis in rats. Passive transfer with serum and evidence that IgG anticollagen antibodies can cause arthritis
J Exp Med
Auricular chondritis in rats
J Exp Med
Corneal autoimmunity in a patient with relapsing polychondritis
Eur Arch Otorhinolaryngol
Susceptibility to relapsing polychondritis is associated with HLA-DR4
Arthritis Rheum
Relapsing polychondritis: Audiovestibular manifestations
Laryngoscope
Head and neck manifestations of relapsing polychondritis: Review of 29 cases
Otolaryngology
Respiratory complications of relapsing polychondritis
Thorax
The arthropathy of relapsing polychondritis
Arthritis Rheum
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Address reprint requests to C. Stephen Foster, MD, FACS, Uveitis and Immunology Service, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114. E-mail: [email protected].