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Vol. 3. Issue 4.
Pages 166-170 (July - August 2007)
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Vol. 3. Issue 4.
Pages 166-170 (July - August 2007)
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Policondritis recidivante: análisis de 11 pacientes
Relapsing Polychondritis: An Analysis of 11 Patients
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Ana Cristina Pérez Gudiñoa, Gustavo E. Lugo Zamudioa,
Corresponding author
gar31@prodigy.net.mx

Correspondencia: Dr. G.E. Lugo Zamudio. Avda. Instituto Politécnico Nacional 5160. Col. Magdalena de las Salinas. CP 07760 México D.F. México.
, Ana S. Vargas Avilesa, Fedra Irazoque Palazuelosb, Lilia Andrade Ortegab, Gabriel Medrano Ramírezc, Claudia Meléndez Mercadoc
a Servicio de Reumatología. Hospital Juárez. México
b Servicio de Reumatología. Centro Médico 20 de Noviembre. México
c Servicio de Reumatología. Hospital General de México. México
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Objetivo

Analizar 11 casos de policondritis recidivante reportados por 3 centros hospitalarios de México.

Pacientes y método

Se analiza sexo, edad a la presentación de la enfermedad, tiempo de evolución al momento del diagnóstico, manifestaciones clínicas iniciales y durante el seguimiento, tratamiento inicial, así como el esquema terapéutico empleado en la fase “crónica” de la enfermedad.

Resultados

Se describió a 8 mujeres y 3 varones con edad promedio al inicio de 40,8 años. El tiempo de evolución al momento del diagnóstico fue de 4 meses a 4 años. Las principales manifestaciones fueron: condritis auricular en 8 (72,7%) de los casos, hipoacusia en 4 (36,3%) y disfonía en 4 (36,3%). Las complicaciones incluyeron estenosis subglótica en 4 (36,3%) pacientes, epiescleritis en 2 (18,1%), y desprendimiento de retina y córnea con lesion macular en 1 (9%); 2 (18,1%) tuvieron hipoacusia conductiva y sensorial; 2 (18,1%), glomerulonefritis y 1 (9%), insuficiencia mitral y tricuspídea. Todos los pacientes recibieron tratamiento a base de prednisona. Los inmunosupresores más usados fueron: ciclofosfamida, metotrexato y azatioprina.

Conclusiones

Ésta es la mayor serie publicada en México y comparte datos clínicos y de evolución comunicados en otras series y en la literatura. La respuesta a esteroides es buena; sin embargo, es necesario considerar otras opciones terapéuticas, ya que la enfermedad continua progresando y recidivando.

Palabras clave:
Policondritis recidivante
Cartílago
Manifestaciones clínicas
Terapéutica
Objective

To analyze 11 patients with relapsing polychondritis reported by 3 hospitals in our country.

Patients and method

We describe 11 cases of relapsing polychondritis reported by 3 hospitals in our country, analizing gender, age at the beginning of the disease, delay time in diagnosis, clinical manifestations at the beginning of the disease and during follow-up, initial treatment, and treatment in the “chronic phase” of the disease.

Results

We described 8 female patients and 4 males, with a mean age of 40.8 years. The delay time in diagnosis was from 4 months to 4 years. The main manifestations were: auricular chondritis in 8 patients (72.7%), hearing loss in 4 (36.3%), and dysphonia in 4 (36.3%). The complications included subglotic stenosis in 4 patients (36.3%), epiescleritis in 2 (18.1%), 1 retinal and corneal dettachment with macular lesion (9%), conductive and sensorial hearing loss in 2 (18.1%), glomerulonephritis in 2 (18.1%), and mitral and tricuspid insufficiency in one patient (9.0%). All of them received prednisone. Cyclophosphamide, methotrexate, and azathioprine were the most common immunosupressors used.

Conclusions

This is the largest cohort reported in our country, sharing clinical and outcome patterns reported in other series and in the literature. Response to steroids is good, however, we need to consider other therapeutic options because the disease continues progressing and relapsing.

Key words:
Relapsing polychondritis
Cartilage
Clinical manifestations
Therapeutics
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Copyright © 2007. Elsevier España S.L Barcelona
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