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RELAPSING POLYCHONDRITIS

Therapeutic Approach

Relapsing polychondritis (RP) is a rare multisystemic autoimmune disease characterized by relapsing-remitting inflammatory destruction of cartilage with auricular, nasal, and laryngo-tracheobronchial cartilages most typically involved. However, clinical presentation is highly variable and may include ocular, vestibular, cutaneous, vascular, valvular, and joint inflammation. Due to its relative rarity, high-quality treatment data are lacking and therapy is largely empirical. In the authors’ experience, limited disease is typically managed symptomatically with NSAIDs. For moderate to severe cases or acute exacerbations, high-dose corticosteroids are used and slowly tapered. Various adjunctive medications may be used or trialed for refractory cases, but evidence is limited and therapy is tailored to clinical response. See Table 56-1.

Table 56-1Relapsing Polychondritis Treatment Table

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