Figures
- FIGURE 1
a) Admission computed tomography (CT) scan showing near complete collapse of trachea in a patient that was subsequently diagnosed with relapsing polychondritis. b) Repeat CT after intravenous corticosteroids with inspiratory and expiratory films showing significant improvement of tracheal narrowing (expiratory phase CT).
- FIGURE 2
a) Patient with admission computed tomography (CT) chest showing near complete collapse of trachea and pleural effusions. b) Repeat CT after treatment with high-dose corticosteroids with improvement in trachea and resolution of pleural effusions.
- FIGURE 3
Patient with collapse of trachea.
- FIGURE 4
a) Patient with presentation computed tomography showing significant narrowing of trachea. b) Post-treatment imaging showing improvement in dimensions of trachea.
- FIGURE 5
Pre-treatment tracheal collapse in a patient.
- FIGURE 6
Patient images demonstrating auricular chondritis with inflammation of the external ear with sparing of non-cartilaginous part.
- FIGURE 7
Flow–volume loop of patient 4 showing flattening of the expiratory limb and inspiratory limb to a lesser extent.
- FIGURE 8
Flow–volume curve of patient 6 showing flattening of the expiratory limb and inspiratory limb to a lesser extent.
Tables
- TABLE 1
Clinical features of patients with relapsing polychondritis
Patient Sex Age years Comorbidities BAC NC RTC SP OI AD Response to corticosteroids TBM proven 1 M 65 T2DM, hypothyroid, psoriasis Y Y Y N Y N Y Y 2 F 70 Memory loss N Y Y Y N N Y Y 3 F 50 T2DM Y Y Y Y N Y Y Y 4 F 53 Hypothyroid, fibromyalgia, HTN, Behçet's, obesity Y Y Y Y N N Y Y 5 F 76 Previous TB, immunodeficiency, HTN, T2DM, OA N N Y Y N Y Y Y 6 F 74 HTN, angina, AF, T2DM, antiphospholipid antibodies Y Y Y Y N N Y Y 7 F 76 Emphysema N N Y N N N Y Y 8 F 70 HTN, obesity, acoustic neuroma, hyperlipidaemia N N Y Y N N Y Y 9 F 78 T2DM, obesity, MI, AF, CKD, dementia, asthma Y Y Y Y N Y Y Y 10 M 31 Hypoadrenalism, bronchiectasis Y Y Y Y N N Y Y 11 F 52 Obesity, COPD, ankylosing spondylitis, psoriasis Y Y N Y N Y Y N 12 M 79 Myelodysplasia, follicular lymphoma, osteoporosis Y N Y N Y N Y N 13 M 78 T2DM, IHD, CKD, myositis N N Y Y N Y Y Y BAC: bilateral auricular chondritis; NC: nasal chondritis; RTC: respiratory tract chondritis; SP: seronegative polyarthritis; OI: ocular inflammation; AD: audiovestibular damage; TBM: tracheobronchomalacia; T2DM: type 2 diabetes mellitus; HTN: hypertension; TB: tuberculosis; OA: osteoarthritis; AF: atrial fibrillation; MI: myocardial infarction; CKD: chronic kidney disease; IHD: ischaemic heart disease.
- TABLE 2
Pharmacological and non-pharmacological treatment for patients with relapsing polychondritis
Patient Sex Age years CPAP Stent IS drugs Corticosteroid dose Previous drugs Baseline RPDAI 1 M 65 N N MTX Pred 37 2 F 70 N N MMF, infliximab Pred 5 mg SSZ 27 3 F 50 DNT N MTX Pred 45 4 F 53 Y Y MMF, MTX Pred 10 mg AZA, cyclophosphamide, ADA and ETN 47 5 F 76 Y N SSZ, HCQ, ABT, IVIG Pred 7.5 mg MTX, ETN, leflunomide, AZA 44 6 F 74 Y Y MTX, AZA Pred 10 mg Cyclophosphamide 43 7 F 76 Y N Cyclophosphamide Pred 10 mg MTX 27 8 F 70 N N AZA Pred 5 mg 15 9 F 78 DNT N Pred 5 mg MTX, AZA, HCQ 24 10 M 31 N N HCT 20/10/10 33 11 F 52 N N Secukinumab Pred 10 mg MTX, ETN, HCQ, cyclophosphamide, ADA 38 12 M 79 N N Pred 5 mg 35 13 M 78 Y Y MTX Pred 5 mg AZA 40 CPAP: continuous positive airway pressure; IS: immunosuppressant; RPDAI: Relapsing Polychondritis Activity Index; MTX: methotrexate; Pred: prednisolone; MMF: mycophenolate mofetil; SSZ: sulfasalazine; DNT: did not tolerate; AZA: azathioprine; ETN: etanercept; HCQ: hydroxychloroquine; ABT: abatacept; IVIG: intravenous immunoglobulin; HCT: hydrocortisone; ADA: adalimumab.
