Relapsing polychondritis: An autoimmune disease with many faces.

Relapsing polychondritis (RPC) is a rare immune mediated disease which is associated with inflammation in cartilaginous tissue throughout the body. Especially the cartilaginous structures of ear, nose, joints and respiratory tract are affected. In around 30% of the cases an association with other diseases especially systemic vasculitis or myelodysplatic syndrome can be detected. The relative rarity of RPC has not permitted clinical trials to determine the efficacy and safety of therapy strategies. Often the medication in current use is largely empiric and based on case reports. Therefore different immunosuppressants such as cyclophosphamide, azathioprine, cyclosporine, mycophenolate mofetil and also new approaches like tumor necrosis factor alpha blockers (TNF-alpha antagonists) have been used for the treatment of severe manifestations of RPC with varying degrees of efficacy. This review gives a close look to clinical manifestation, diagnosis and also therapy options of RPC.

[1]  Y. Tsunezuka,et al.  Tracheobronchial Involvement in Relapsing Polychondritis , 2000, Respiration.

[2]  J. Esdaile,et al.  Vascular involvement in relapsing polychondritis. , 1977, Canadian Medical Association journal.

[3]  S. Sabanathan,et al.  Airway complications in relapsing polychondritis. , 1991, The Annals of thoracic surgery.

[4]  A. Tyndall Hematopoietic stem cell transplantation in rheumatic diseases other than systemic sclerosis and systemic lupus erythematosus. , 1997, The Journal of rheumatology. Supplement.

[5]  S. Keshavjee,et al.  Treatment of diffuse tracheomalacia secondary to relapsing polychondritis with continuous positive airway pressure. , 1997, Chest.

[6]  M. Gimovsky,et al.  Relapsing polychondritis in pregnancy: a case report and review. , 1989, American journal of obstetrics and gynecology.

[7]  J. Girón,et al.  Airway complications in relapsing polychondritis. , 1993, The Journal of rheumatology.

[8]  D. T. Cody,et al.  Relapsing polychondritis: Audiovestibular manifestations , 1971, The Laryngoscope.

[9]  D. Heinegård,et al.  A new animal model for relapsing polychondritis, induced by cartilage matrix protein (matrilin-1). , 1999, The Journal of clinical investigation.

[10]  J. Butcher,et al.  The successful use of infliximab in resistant relapsing polychondritis and associated scleritis , 2005, Eye.

[11]  A. Del Rosso,et al.  Cardiovascular involvement in relapsing polychondritis. , 1997, Seminars in arthritis and rheumatism.

[12]  T. Schaeverbeke,et al.  Successful treatment of relapsing polychondritis with infliximab. , 2004, Clinical and experimental rheumatology.

[13]  G. Valesini,et al.  Biological and clinical effects of anti-TNFalpha treatment. , 2007, Autoimmunity reviews.

[14]  K. Offord,et al.  Renal Involvement in Relapsing Polychondritis , 1987, Medicine.

[15]  T. Liesegang,et al.  Ocular and systemic findings in relapsing polychondritis. , 1986, Ophthalmology.

[16]  R. P. Handler Leflunomide for relapsing polychondritis: successful longterm treatment. , 2006, The Journal of rheumatology.

[17]  A. Rajput,et al.  Nervous system complications of relapsing polychondritis , 1983, Neurology.

[18]  D. Heinegård,et al.  Serum concentrations of two cartilage matrix proteins reflecting different aspects of cartilage turnover in relapsing polychondritis. , 1995, Arthritis and rheumatism.

[19]  M. Cutolo,et al.  Use of glucocorticoids and risk of infections. , 2008, Autoimmunity reviews.

[20]  J. Schölmerich,et al.  Relapsing polychondritis: clinical and immunogenetic analysis of 62 patients. , 1997, The Journal of rheumatology.

[21]  J. H. Herman,et al.  Immunopathologic studies in relapsing polychondritis. , 1973, The Journal of clinical investigation.

[22]  A. Aouba,et al.  Complete remission in refractory relapsing polychondritis with intravenous immunoglobulins. , 2008, Clinical and experimental rheumatology.

[23]  M. Sheppard,et al.  Active aortitis in relapsing polychondritis. , 2001, Journal of clinical pathology.

[24]  G. Goldenberg,et al.  Successful treatment of relapsing polychondritis with mycophenolate mofetil , 2006, The Journal of dermatological treatment.

[25]  Richard O. Williams,et al.  Prolonged response to anti-tumour necrosis factor treatment with adalimumab (Humira) in relapsing polychondritis complicated by aortitis. , 2007, Rheumatology.

[26]  J. Piette,et al.  Dermatologic Manifestations of Relapsing Polychondritis: A Study of 200 Cases at a Single Center , 2001, Medicine.

[27]  M. Kawai,et al.  Sustained response to tocilizumab, anti-interleukin-6 receptor antibody, in two patients with refractory relapsing polychondritis. , 2008, Rheumatology.

[28]  A. Ormerod,et al.  Relapsing polychondritis—two cases with tracheal stenosis and inner ear involvement , 1992, The Journal of Laryngology & Otology.

[29]  J. Piette,et al.  Serum cytokine profiles in relapsing polychondritis suggest monocyte/macrophage activation. , 2004, Arthritis and rheumatism.

[30]  O. Meyer,et al.  Antineutrophil cytoplasmic antibodies in polychondritis. , 1993, Annals of the rheumatic diseases.

[31]  M. Turiel,et al.  Cardiovascular involvement in systemic autoimmune diseases. , 2009, Autoimmunity reviews.

[32]  G. Sakellariou,et al.  Refractory relapsing polychondritis: rapid and sustained response in the treatment with an IL-1 receptor antagonist (anakinra). , 2006, Rheumatology.

[33]  D. Feller-Kopman,et al.  Relapsing polychondritis: prevalence of expiratory CT airway abnormalities. , 2006, Radiology.

[34]  R. Hyatt,et al.  Pulmonary function in relapsing polychondritis. , 1986, The American review of respiratory disease.

[35]  B. Richardson,et al.  The genetics and epigenetics of autoimmune diseases. , 2009, Journal of autoimmunity.

[36]  C. Pearson,et al.  RELAPSING POLYCHONDRITIS: Prospective Study of 23 Patients and A Review of the Literature , 1976, Medicine.

[37]  J. Piette,et al.  Leg bone pain syndrome in a kidney transplant patient treated with tacrolimus (FK506) , 1998, Annals of the rheumatic diseases.

[38]  Stewart Ka,et al.  Pulse intravenous cyclophosphamide for kidney disease in relapsing polychondritis. , 1992 .

[39]  D. Barad,et al.  Gender as risk factor for autoimmune diseases. , 2007, Journal of autoimmunity.

[40]  J. Foidart,et al.  Antibodies to type II collagen in relapsing polychondritis. , 1978, The New England journal of medicine.

[41]  P. Rubin,et al.  Obliterative Microangiopathy Presenting as Chronic Conjunctivitis in a Patient With Relapsing Polychondritis , 2006, Cornea.

[42]  H. Schumacher,et al.  Steroid sparing effect of methotrexate in relapsing polychondritis. , 1996, The Journal of rheumatology.

[43]  C. Marquette,et al.  Respiratory Involvement in Relapsing Polychondritis: Clinical, Functional, Endoscopic, and Radiographic Evaluations , 1998, Medicine.

[44]  V. Riccieri,et al.  A case of relapsing polychondritis: pathogenetic considerations. , 1988, Clinical and Experimental Rheumatology.

[45]  H. Levine,et al.  Relapsing polychondritis — REPORT OF TEN CASES , 1979, The Laryngoscope.

[46]  E. Albert,et al.  A novel variant of DR4 (DRB1*0421) identified in a patient with polychondritis , 2004, Immunogenetics.

[47]  W. Kwok,et al.  Identification of type II collagen peptide 261-273-specific T cell clones in a patient with relapsing polychondritis. , 2002, Arthritis and rheumatism.

[48]  D. Doniach,et al.  Autoantibodies to cartilage and type II collagen in relapsing polychondritis and other rheumatic diseases. , 1981, Annals of the rheumatic diseases.

[49]  C. Dooms,et al.  Performance of Fully Covered Self-Expanding Metallic Stents in Benign Airway Strictures , 2009, Respiration.

[50]  J. Carter Treatment of relapsing polychondritis with a TNF antagonist. , 2005, The Journal of rheumatology.

[51]  A. Testori,et al.  Hematopoietic stem cell transplantation for autoimmune diseases: what have we learned? , 2008, Journal of autoimmunity.

[52]  J. Piette,et al.  Treatment of relapsing polychondritis with rituximab: a retrospective study of nine patients. , 2009, Arthritis and rheumatism.