Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender

Abstract

The comorbidities in relapsing polychondritis have been scarcely described in the literature. Moreover, apart from a few relapsing polychondritis epidemiological studies, no studies specifically addressing relapsing polychondritis distribution according to gender are available. Therefore, the objectives of the present study were: (a) to analyze the prevalence of cardiovascular diseases and its risk factors in a series of patients with relapsing polychondritis; (b) to determine the influence of gender on relapsing polychondritis. A cross-sectional tertiary single center study evaluating 30 relapsing polychondritis cases from 1990 to 2016 was carried out. To compare comorbidities, 60 healthy individuals matched for age-, gender-, ethnicity- and body mass index were recruited. The mean age of relapsing polychondritis patients was 49.0±12.4 years, the median disease duration 6.0 years, and 70% were women. A higher frequency of arterial hypertension (53.3% vs. 23.3%; p=0.008) and diabetes mellitus (16.7% vs. 3.3%; p=0.039) was found in the relapsing polychondritis group, compared to the control group. As an additional analysis, patients were compared according to gender distribution (9 men vs. 21 women). The clinical disease onset features were comparable in both genders. However, over the follow-up period, male patients had a greater prevalence of hearing loss, vestibular disorder and uveitis events, and also received more cyclophosphamide therapy (p<0.05). There was a high prevalence of arterial hypertension and diabetes mellitus, and the male patients seemed to have worse prognosis than the female patients in the follow up.

Relapsing polychondritis: state of the art on clinical practice guidelines

“… 12 Three phenotypes with different presentations have been recently described in a cluster analysis of a cohort: a haematological form (in 10% of cases), a respiratory form (in 25%) and a mild one with good prognosis (about 65% of cases). 15 Some complications such as aortitis, 18 vasculitis 4 or anaemia are pejorative prognosis factors. 4 In addition, the male gender is associated with worse prognosis and higher prevalence of uveitis, hearing loss, vestibular disorder, as well as greater necessity for methylprednisolone and cyclophosphamide pulses.…”

“…In a recent large study, aortic involvement, consisting of aneurysms or ectasia, mainly of the thoracic and abdominal aorta, occurred in 6.4% of cases, after a median follow-up of 2 years. 18 An older study showed that a close vascular follow-up is needed in RP and that reintervention may be necessary in some cases. 26 In a recent series, up to 22% of patients had a cardiac valvulopathy, usually not severe.…”

“…However, in a recent study, aortic complications were detected at ≈2 years from diagnosis. 18 Arthritis and the ocular features may be inaugural or may appear anytime during the disease. For respiratory involvement, a thorax CT scan 35 may reveal oedematous tracheobronchial wall thickening with or without mural calcifications, deformity of cartilaginous structures, and narrowing of the trachea and bronchi.…”

Replasing Polychondritis and Geriatrics: Report of Two Cases

“…However, the comorbidities in RP have been scarcely described in the literature. Notably, tow studies, reporting the incidence, and prevalence of cardiovascular diseases and their risk factors( Arterial hypertension, Diabete smellitus, Dyslipidemia; Cardiac insufficiency, Myocardial infarction, Stroke, old age ) [1,27].…”

“…Mortality in RP is more than twice of the general population [1] and the most frequent causes of death are respiratory disease, heart conditions and cancer [1,7,19,27];The most cases concluded that there is an increased relative risk of malignancy in RP with old age [22].…”