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Polychondritis or relapsing polychondritis is an uncommon illness that many doctors feel may be autoimmune in nature. In this condition, cartilage in the body is most affected, though other connective tissues may also be involved. The cartilage starts to deteriorate, which can cause pain around the joints, and affect the ears and/or nose resulting in swelling and inflammation.
The name relapsing polychondritis is important because the condition tends to occur in episodes that are a few weeks in length. After a flare pain can subside but will return with another attack. Ultimately, repeated attacks can damage cartilage, changing the appearance of nose and ears and affecting some function of other areas of the body.
The principal symptoms of polychondritis include inflammation of the ears, pain in the breastbone, and swelling of the nose. People often have fevers, overall achiness and joint pain during episodes. Sometimes the condition causes breathing difficulties, a husky voice, or a cough.
In complicated flares, other parts of the body like the heart or eyes may be involved. Some people particularly note that their hearing is affected and they could report losing their balance or having vertigo from hearing changes. Another symptom can be rashes on various parts of the body, but it should be noted that people can have fewer symptoms and still have this condition, and that each flare could have different symptoms.
Should people present with symptoms of fever, swollen ears, and joint pain, doctors may want to test for polychondritis. Testing is normally accomplished by taking a sample of cartilage to see if it has the characteristic symptoms of damage. Other tests could be performed too, including bloodwork, which may look for irregularities in white blood count and cardiovascular exams to see if the heart is impaired.
If diagnosed, there are several ways to treat polychondritis. People with mild cases may respond well when they take non-steroidal anti-inflammatory drugs (NSAIDs), which may be as mild as ibuprofen or might be stronger prescription NSAIDs. Some people do not get enough relief from inflammation with these medicines, and another common strategy is to treat flares with steroids like prednisone. Alternately, there are medications that are immunosuppressants or which block immune response. Some people have responded well to treatment with immunosuppressive drugs, strongly suggesting that this illness is autoimmune in nature.
People with this illness will need careful monitoring with a physician, and often with a rheumatologist. As cartilage damage accumulates with repeated flares, there is not just discomfort but also danger of severe conditions occurring, like collapse of the trachea, which immediately blocks breathing. Another complication for some people is development of severe heart problems that could cause congestive heart failure or necessitate immediate repair.
Though polychondritis is rare, it is not so rare that it doesn’t require greater study and understanding, with an eye to finding out how to prevent the illness. Though medical researchers now know some things about the disease, like the fact that it most often occurs in middle age, they still don’t know enough. Further research is needed to find more efficacious treatments and perhaps to evolve a cure.
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