Hostname: page-component-77f85d65b8-2tv5m Total loading time: 0 Render date: 2026-03-27T13:48:54.074Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical analysis of relapsing polychondritis with airway involvement

Published online by Cambridge University Press:  02 February 2022

S-Y Zhai ,
R-Y Guo ,
C Zhang ,
C-M Zhang ,
H-Y Yin ,
B-Q Wang  and
S-X Wen Open the ORCID record for S-X Wen [Opens in a new window]
S-Y Zhai
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, First Clinical College of Shanxi Medical University, Taiyuan, Shanxi, China
R-Y Guo
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, First Clinical College of Shanxi Medical University, Taiyuan, Shanxi, China
C Zhang
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
C-M Zhang
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China Shanxi Key Laboratory of Otolaryngology Head and Neck Cancer, Taiyuan, Shanxi, China
H-Y Yin
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Kunshan Maternal and Child Health Hospital, Kunshan, Jiangsu, China
B-Q Wang
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China Shanxi Key Laboratory of Otolaryngology Head and Neck Cancer, Taiyuan, Shanxi, China
S-X Wen*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery, Shanxi Bethune Hospital (Third Hospital of Shanxi Medical University), Taiyuan, Shanxi, China
*
Author for correspondence: Dr Shuxin Wen, Department of Otorhinolaryngology Head and Neck Surgery, Shanxi Bethune Hospital (aka Third Hospital of Shanxi Medical University), No. 99 Longcheng Street, Taiyuan 030000, Shanxi, China E-mail: wensxsx@163.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To identify the clinical characteristics, treatment, and prognosis of relapsing polychondritis patients with airway involvement.

Methods

Twenty-eight patients with relapsing polychondritis, hospitalised in the First Hospital of Shanxi Medical University between April 2011 and April 2021, were retrospectively analysed.

Results

Fifty per cent of relapsing polychondritis patients with airway involvement had a lower risk of ear and ocular involvement. Relapsing polychondritis patients with airway involvement had a longer time-to-diagnosis (p < 0.001), a poorer outcome following glucocorticoid combined with immunosuppressant treatment (p = 0.004), and a higher recurrence rate than those without airway involvement (p = 0.004). The rates of positive findings on chest computed tomography and bronchoscopy in relapsing polychondritis patients with airway involvement were 88.9 per cent and 85.7 per cent, respectively. Laryngoscopy analysis showed that 66.7 per cent of relapsing polychondritis patients had varying degrees of mucosal lesions.

Conclusion

For relapsing polychondritis patients with airway involvement, drug treatment should be combined with local airway management.

Keywords

Polychondritis, RelapsingLarynxTracheaDiagnosisTreatment

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 1 , January 2023 , pp. 96 - 100
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Dr S-X Wen takes responsibility for the integrity of the content of the paper

References

Chen, N, Wang, Z. Progress in the pathology and pathogenesis of relapsing polychondritis. Chinese Journal of Rheumatology 2019;3:207–11Google Scholar
Hazra, N, Dregan, A, Charlton, J, Gulliford, MC, D'Cruz, DP. Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study. Rheumatology (Oxford) 2015;54:2181–7Google Scholar
Damiani, JM, Levine, HL. Relapsing polychondritis--report of ten cases. Laryngoscope 1979;89:929–46Google ScholarPubMed
McAdam, LP, O'Hanlan, MA, Bluestone, R, Pearson, CM. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine (Baltimore) 1976;55:193–215CrossRefGoogle Scholar
Longo, L, Greco, A, Rea, A, Lo Vasco, VR, De Virgilio, A, De Vincentiis, M. Relapsing polychondritis: a clinical update. Autoimmun Rev 2016;15:539–43CrossRefGoogle ScholarPubMed
Smylie, A, Malhotra, N, Brassard, A. Relapsing polychondritis: a review and guide for the dermatologist. Am J Clin Dermatol 2017;18:77–86CrossRefGoogle ScholarPubMed
Eng, J, Sabanathan, S. Airway complications in relapsing polychondritis. Ann Thorac Surg 1991;51:686–92CrossRefGoogle ScholarPubMed
de Montmollin, N, Dusser, D, Lorut, C, Dion, J, Costedoat-Chalumeau, N, Mouthon, L et al. Tracheobronchial involvement of relapsing polychondritis. Autoimmun Rev 2019;18:102353CrossRefGoogle ScholarPubMed
Dion, J, Costedoat-Chalumeau, N, Sène, D, Cohen-Bittan, J, Leroux, G, Dion, C et al. Relapsing polychondritis can be characterized by three different clinical phenotypes: analysis of a recent series of 142 patients. Arthritis Rheumatol 2016;68:2992–3001CrossRefGoogle ScholarPubMed
Shimizu, J, Yamano, Y, Kawahata, K, Suzuki, N. Relapsing polychondritis patients were divided into three subgroups: patients with respiratory involvement (R subgroup), patients with auricular involvement (A subgroup), and overlapping patients with both involvements (O subgroup), and each group had distinctive clinical characteristics. Medicine (Baltimore) 2018;97:e12837CrossRefGoogle ScholarPubMed
Zhang, H, Wang, L, Yan, L, Yang, J, Wu, C, Wu, D et al. Clinical characteristics of patients with recurrent polyrickets [in Chinese]. National Medical Journal of China 2015;95:2375–8Google Scholar
Lin, DF, Yang, WQ, Zhang, PP, Lv, Q, Jin, O, Gu, JR. Clinical and prognostic characteristics of 158 cases of relapsing polychondritis in China and review of the literature. Rheumatol Int 2016;36:1003–9CrossRefGoogle ScholarPubMed
Wang, Z, Chen, N, Cui, L, Gao, Y, Wang, Y. Insidious airway involvement in patients with relapsing polychondritis [in Chinese]. Chinese Journal of Rheumatology 2018;22:452–8Google Scholar
Zhang, L, Yun, S, Wu, TG, He, Y, Guo, J, Han, L et al. Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study. Orphanet J Rare Dis 2021;16:225CrossRefGoogle ScholarPubMed
Ernst, A, Rafeq, S, Boiselle, P, Sung, A, Reddy, C, Michaud, G et al. Relapsing polychondritis and airway involvement. Chest 2009;135:1024–30CrossRefGoogle ScholarPubMed
Dubey, S, Gelder, C, Pink, G, Ali, A, Taylor, C, Shakespeare, J et al. Respiratory subtype of relapsing polychondritis frequently presents as difficult asthma: a descriptive study of respiratory involvement in relapsing polychondritis with 13 patients from a single UK centre. ERJ Open Res 2021;7:00170–2020CrossRefGoogle ScholarPubMed
Shi, X, Tong, S, Su, J, Huang, H, Zhang, F, Tang, F et al. Characteristics of airway involvement in relapsing polychondritis [in Chinese]. National Medical Journal of China 2006;86:1048–51Google ScholarPubMed
Thaiss, WM, Nikolaou, K, Spengler, W, Spira, D, Xenitidis, T, Henes, J et al. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data. Skeletal Radiol 2016;45:339–46CrossRefGoogle ScholarPubMed
Kubota, K, Yamashita, H, Mimori, A. Clinical value of FDG-PET/CT for the evaluation of rheumatic diseases: rheumatoid arthritis, polymyalgia rheumatica, and relapsing polychondritis. Semin Nucl Med 2017;47:408–24CrossRefGoogle ScholarPubMed
Kamada, H, Takanami, K, Toyama, Y, Saito, M, Takase, K. 18F-FDG PET/CT imaging of vasculitis complicated with relapsing polychondritis. Clin Nucl Med 2020;45:e327–8CrossRefGoogle ScholarPubMed
Chen, Y, Pan, X, Guan, Y, Yang, X, Liu, H, Chen, P et al. 18F-FDG PET/CT in diagnosis of relapsing polychondritis [in Chinese]. Chinese Medical Image Technology 2019;35:138–42Google Scholar
Lei, W, Zeng, H, Zeng, DX, Zhang, B, Zhu, YH, Jiang, JH et al. (18)F-FDG PET-CT: a powerful tool for the diagnosis and treatment of relapsing polychondritis. Br J Radiol 2016;89:20150695CrossRefGoogle ScholarPubMed
Guo, Z, Zhao, D, Xing, Y, Liang, L, Yang, J, Zhao, Q et al. Diagnosis and treatment of laryngotracheal stenosis induced by relapsing polychondritis [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020;34:524–7Google ScholarPubMed
Oryoji, D, Ono, N, Himeji, D, Yoshihiro, K, Kai, Y, Matsuda, M et al. Sudden respiratory failure due to tracheobronchomalacia by relapsing polychondritis, successfully rescued by multiple metallic stenting and tracheostomy. Intern Med 2017;56:3369–72CrossRefGoogle ScholarPubMed
Wu, X, Zhang, X, Zhang, W, Huang, H, Li, Q. Long-term outcome of metallic stenting for central airway involvement in relapsing polychondritis. Ann Thorac Surg 2019;108:897–904CrossRefGoogle ScholarPubMed
Wang, H-W. Strict control of tracheal stent indications, timely treatment of complications. Chinese Journal of Tuberculosis and Respiratory Diseases 2014;37:221–2Google Scholar
Li, W-Y, He, L, Zhang, L-S. Laryngotracheobronchial involvement in relapsing polychondritis [in Chinese]. Zhonghua Er Bi Yan Hou Ke Za Zhi 1999;34:314–16Google ScholarPubMed
Xie, C, Shah, N, Shah, PL, Sandhu, G. Laryngotracheal reconstruction for relapsing polychondritis: case report and review of the literature. J Laryngol Otol 2013;127:932–5CrossRefGoogle ScholarPubMed
Lekpa, FK, Chevalier, X. Refractory relapsing polychondritis: challenges and solutions. Open Access Rheumatol 2018;10:1–11CrossRefGoogle ScholarPubMed
Yu, C, Joosten, SA. Relapsing polychondritis with large airway involvement. Respirol Case Rep 2020;8:e00501CrossRefGoogle ScholarPubMed