Comparison of relapsing polychondritis patients with and without central nervous system involvement: A retrospective study of 181 patients

Abstract

The relapsing polychondritis (RP) patients with central nervous system (CNS) involvement were rare. We aimed to determine the clinical characteristics of RP patients with CNS involvement. The clinical data of 181 RP patients, hospitalized at Peking Union Medical College Hospital between December 2005 and February 2019, were collected. The patients were categorized into two subgroups: 25 RP patients with CNS involvement, and 156 RP patients without CNS involvement. The involvement of the ear was more frequent in RP patients with CNS involvement, compared with those of RP patients without CNS involvement ( P < 0.01). After controlling sex and the admission age, logistic regression analysis revealed hypertension (odds ratio = 4.308, P = 0.006) and involvement of eye (odds ratio = 5.158, P = 0.001) and heart (odds ratio = 3.216, P = 0.025) were correlated with RP patients with CNS involvement, respectively. In addition, pulmonary infection (odds ratio = 0.170, P = 0.020), tracheal involvement (odds ratio = 0.073, P < 0.01), and involvement of laryngeal (odds ratio = 0.034, P = 0.001), costochondral joint (odds ratio = 0.311, P = 0.013), sternoclavicular joint (odds ratio = 0.163, P = 0.017) and manubriosternal joint (odds ratio = 0.171, P = 0.021) were associated with RP patients without CNS involvement, respectively. In contrast to RP patients without CNS involvement, the incidence of ear involvement was higher in RP patients with CNS involvement. After controlling the potential confounding factor sex and the admission age, hypertension and involvement of eye and heart were related with RP patients with CNS involvement, respectively.

Bronchoscopy-Guided Intervention Therapy With Extracorporeal Membrane Oxygenation Support for Relapsing Polychondritis With Severe Tracheobronchomalacia: A Case Report and Literature Review

“…The second is rhinochondritis, which often manifests as nasal congestion, pain, and even “saddle nose” deformity, but it rarely manifests as epistaxis ( 6 ). Moreover, the involvement of organs such as the heart, eyeballs, joints, skin, and nervous system are also common ( 7 ). RP usually occurs between 40 and 60 years of age, and fever, fatigue, weight loss, or skin rash may be the first symptoms ( 8 ).…”

Ocular Involvement in Relapsing Polychondritis

“…The cumulative prevalence of the ocular symptoms in RPC varies by studies, but they have been reportedly observed in 20-61% of patients with RPC (Table 2) [2,4,[6][7][8][9][12][13][14][15][16][17][18]. Common ocular manifestations are scleritis, uveitis, conjunctivitis, and keratitis (Table 3).…”

“…Cao et al analyzed patients with RPC with central nervous system involvement. Of the 25 patients, two had optic nerve involvement, two had oculomotor nerve involvement, one had trigeminal nerve involvement, and one had abducens nerve involvement [12].…”

Teaching NeuroImage: Seizures as the Initial Symptom of Relapsing Polychondritis

“…Only 3%-13.81% of RP patients exhibited CNS involvement and CNS manifestations were heterogeneous 1 . RP with onset of seizures is rare.…”

“…Only 3%-13.81% of the patients with RP exhibited CNS involvement, and CNS manifestations were heterogeneous. 1 RP with onset of seizures is rare. A previous autopsy report showed extensive cerebral and systemic vasculitis in RP.…”