Relapsing Polychondritis: A Case Report and Review of the Japanese Literature

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  • Hirai Nobuyuki
    Department of Dermatology, Gunma University Graduate School of Medicine
  • Amano Hiroo
    Department of Dermatology, Gunma University Graduate School of Medicine
  • Yamanaka Masayoshi
    Department of Dermatology, Gunma University Graduate School of Medicine
  • Ishikawa Osamu
    Department of Dermatology, Gunma University Graduate School of Medicine

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Other Title
  • 抗II型コラーゲン抗体陽性再発性多発軟骨炎の1例（本邦報告例124例のまとめ）
  • 抗2型コラーゲン抗体陽性再発性多発軟骨炎の1例(本邦報告例124例のまとめ)
  • コウ2ガタ コラーゲン コウタイ ヨウセイ サイハツセイ タハツ ナンコツエン ノ 1レイ ホンポウ ホウコクレイ 124レイ ノ マトメ

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Abstract

We report a case of a 76-year-old Japanese woman with a two-month history of recurrent, swelling erythema on both ears. Histological examination revealed dense mononuclear cell infiltrations surrounding the cartilaginous tissue and infiltration of mononuclear cells into the cartilage. Laboratory examination disclosed the presence of anti-type II collagen, anti-thyroglobulin and anti-microsomal antibodies. Computed tomography (CT) showed a diffuse swelling of the thyroid gland. A diagnosis of relapsing polychondritis (RP) complicated by Hashimotoʼs thyroiditis was established. In Japan, 124 cases of RP have been reported within the last 10 years. We reviewed the complications and treatments and compared the clinical difference between anti-type II collagen antibody-positive and negative patients. Anti-type II collagen antibody was positive in 45.8% of RP patients (22 cases out of 48 cases). Corticosteroid pulse therapy was required for 27.3% of anti-type II collagen antibody-positive patients, but for only 11.5% of anti-type II collagen antibody-negative patients. Surgical interventions for respiratory complications were indicated in 22.7% of anti-type II collagen antibody positive patients, but in only 3.8% of anti-type II collagen antibody negative patients. These results suggest that anti-type II collagen antibody-positive patients are likely to suffer from more severe chondritis of the respiratory tract.

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