Polychondritis

Polychondritis General Information

Polychondritis is a medical condition characterized as an episodic and progressive multisystem infectious rheumatic disease. If it is left untreated or is not treated properly, this medical disorder can threaten the life of the patient, it can become debilitating and it can be challenging to diagnose. When it has been first discovered, the disease was characterized as recurrent; it presented severe and frightening episodes of inflammation of the patient’s cartilaginous tissues. In most cases the disease tends to affect the cartilage of a certain system that can include ears, nose, larynx, trachea, bronchi and joints. There are also cases in which the disease can affect tissues rich in proteoglycan that can include eyes, aorta, heart, and skin. When the disease affects certain areas, it firstly causes an inflammation that can lead to cartilage destruction.

Affecting one of these systems it can also cause certain symptoms such as difficulty in breathing or shortness of the breath. There are cases in which the patient’s organism can react differently to Polychondritis and he can experience signs such as arthritis, eye inflammation, hearing or balance dysfunction, vasculitis, endocrine system dysfunctions, skin disorders and cranial nerve and brain involvement. The diagnosis for this kind of disease known as Polychondritis is made by a physician and is based on the set of signs and symptoms the patient is experiencing.

Polychondritis Symptoms

Due to the fact that Polychondritis causes no signs and symptoms in the first stages of development it can be challenging to diagnose and treat it. To understand the delayed time from when Polychondritis started to appear and when the first symptoms develop, a review of 70 patients has been made and the reported time was two to three years. There are cases in which many doctors, one after another were not able to diagnose certainly the condition. The signs and symptoms caused by Polychondritis can differ depending on the system that is affected: generally, when the patient experiences intermittent fever, weight loss, and skin rash; audiovestibular, when the patient can experience sudden ear pain, floppy ear, suddenly diminished hearing, inability to sleep on the affected side, persistent or temporary tinnitus, otitis media, vertigo, which can be accompanied by nausea or vomiting, ear drainage and unsteadiness; musculoskeletal, when the patient can experience polvarthiritis, monoarthritis, rib pain, back pain, claudication, and generalized arthralgias; respiratory, when the patient experiences dyspnea, wheezing, exercise intolerance, hoarseness, and certain types of infections; gastrointestinal, when the patient present dyphagia; nasal, when the patient can have a feeling of fullness across his nasal bridge, saddle nose, mild epistaxis, and swollen, particularly red, nose; ocular when the patient can present a decreased visual acuity, conjunctivitis, scleritis, eye inflammation and eyelid swelling; and cardiovascular when the patient can experience chest pain, pericarditis, unusual heart rhythm, and myocardial infraction. These are specific signs and symptoms that may not occur in all the patients.

Polychondritis Treatment

In most cases, Polychondritis is diagnosed considering certain signs and symptoms that the patient presents and that can include inflammation of both ears, painful swelling in several joints, and inflammation of the cartilage of the nose, inflammation of the eyes, cartilage damage in the respiratory system, and hearing or balance disorders. In treating Polychondritis, the main treatment option is the use of corticosteroids. There are cases in which the patient can present other manifestations such as ocular, laryngotracheal, bronchial, renal, cardiovascular and neurological dysfunctions, and the first treatment option is the use of immunosuppressive anti inflammatory medicines. The most common medicine used to treat Polychondritis is Prednisone that is usually administered in doses of 40 mg/d in acute stages and doses of 20 mg/d for maintenance. If the disease has advanced to a more severe stage, doctors increase the doses to 90 mg/d. There are cases when the disease can be successfully treated by applying intermittent treatment of increased doses. Most doctors use a continuous form of the treatment with Prednisone to decrease the severity, frequency and duration of the inflammation episodes.

There are other medicines that can be used to treat the disease which can include Methotrexate, Azathioprine, Cyclophosphamide and Cyclosporine. The drugs can also be useful in controlling the disease’s progression. In addition to the steroid treatment, Methotrexate proved to decrease significantly the corticosteroid requirements while relieving the symptoms. There are cases in which the patients are treated with non steroidal anti inflammatory medicines that are administered orally that have the effect of controlling the inflammation. In more severe cases of Polychondritis, doctors can apply surgical therapy which can consist in applying procedures such as tracheotomy, permanent tracheotomy placement, aortic aneurysm, and cardiac valve replacement. In most cases, the surgical treatment is applied to decrease the risk of developing an infection, particularly if the patient experienced an acute relapse, due to the fact that individuals have an increased risk of developing certain infection when they are treated with corticosteroids.

The medication treatment for Polychondritis differs depending on the tissue that it is affected and the patient’s reactions to certain medicines. There are cases in which the patient can respond well to small amounts of Prednisone or non steroidal anti inflammatory drugs while other patients require a combination of these medicines only to control the disease. There are cases in which the disease has been caused by other more severe affections such as cancer, malaria, certain arthritis disease and autoimmune disease, and the treatment is focused to cure these conditions. Medications that can also be useful in treating the disease can include Chloroquine and Hydroxychloroquine. With the proper treatment applied in time, the patient can recover fully in a matter of months.