Wednesday, June 1, 2011

Policondrita appellant

Policondrita appellant is a severe inflammatory condition, which affects episodic and progressive cartilage structures of the ear, nose and laringotraheobronsic tree. Other affected structures may include the eyes, cardiovascular system, peripheral joints, skin, and internal average toad and central nervous system.
The etiology of this condition is unknown, though it is an autoimmune pathogenesis. Evidence for autoimmune aetiology include infiltration of T lymphocytes, this antigen-antibody complexes in the affected cartilage, cellular and humoral response against type II collagen and other collagen antigens, and the observation that immunosuppressive regimens stop the disease.
The survival rate at 5 years is associated with recurrent policondrita 66-74% and 55% at 10 years. The most common cause of death associated with recurrent policondrita corticosteroid therapy is secondary infection or respiratory compromise, systemic vasculitis and neoplasms. Complications such as deformation policondritei nose, systemic vasculitis, laringotraheala stricture, arthritis and anemia in patients under 50 carries a negative prognosis. Renal impairment has a negative prognosis for all ages.
Policondritei complications including recurrent vertigo, tinnitus, joint deformation, hoarse voice, epiglottis, scleritis, conjunctivitis, iritis, traheotomiei need permanent, severe pulmonary infection, blindness, respiratory insufficiency, aortic regurgitation, mitral, aortic dissection, and glomerulonephritis.
Pathogenesis of recurrent policondriteiHumoral response:The specificity of the autoimmune lesion on cartilage has led researchers to hypothesize that cartilage-specific autoantibodies are critical to the pathogenesis of recurrent policondritei. Various studies show the presence of autoantibodies against collagen II, IX, XI to 70% of patients. It was found that type II collagen autoantibodies are present during the acute phase policondritei and their level correlates with the severity of the episode.Treatment with prednisone reduced antibody titre.
Cellular response:Although inflammatory infiltrates with lymphocytes and neutrophils are the hallmark for the role proved policondrita cellular immune response in this condition. Association with HLA-DR4 policondritei also suggest an autoimmune pathogenesis. Studies show role of genetic factors in the development of recurrent policondritei.
Other autoimmune diseases:The hypothesis of an autoimmune etiology for policondrita appellant is supported by the high prevalence of other autoimmune diseases in patients with policondrita. Policondritei recurrent nature-related diseases include autoimmune: Systemic vasculitis, systemic lupus erythematosus, thyroid disease, rheumatoid arthritis, Sjogren's syndrome, ulcerative colitis, Crohn's disease, Takayasu arteritis, spondiloartropatie, diabetes, Raynaud's syndrome, systemic sclerosis, pernicious anemia, Behcet's disease, psoriasis, primary biliary cirrhosis.
Signs and symptoms in recurrent policondritaThe range of possible symptoms of onset and episodic nature of recurrent policondritei may cause delayed establishment of diagnosis.Systems affected and symptoms reported in patients with recurrent policondrita include:, Intermittent fever, weight loss, rash-Audiovestibulare: sudden unilateral ear pain, unable to sleep on the affected ear hanging, sudden hearing loss, tinnitus, otitis media, ear drainage, vertigo-Musculoskeletal: arthritis and monoarthritis, muscle pain, back pain, rib pain, chest pain, calf pain or claudication, migratory arthralgias or generalized-Respiratory: dyspnea, wheezing, coughing, exercise intolerance, VOGELE raus, recurrent infectionsDysphagia, gastro--Nasal: nasal fullness, his nose, epistaxis easy, nose swollen, red, painfulOcular: low visual acuity, conjunctivitis, episclerita, sclera, ocular inflammation, diplopia, eyelid edema-Cardiovascular: chest pain, abdominal pain, pericarditis, abnormal heart rate or rhythm, syncope, myocardial infarction subacute-Central nervous system: headache, ataxia, confusion, cranial nerve palsy, psychiatric signs, changes in sensation, dementia, seizures.Diagnostic criteria for recurrent policondrita include:Bilateral ear-ZaimStupid-arthritis, inflammatory seronegativeNasal-ZaimOcular-inflammationRespiratory tract-ZaimAudiovestibulare-injury.
Zaim ear:95% of patients develop this event. Unilateral or bilateral ear pain, swelling, redness develops suddenly but avoid the ear lobe. Pain and redness resolve 2-4 weeks but may recur. Ear cartilage is soft and collapses above. External auditory canal collapses after a few episodes. It can develop nodularitatea auricle and calcification.
Seronegative inflammatory arthritis stupid:Grows to 85% of patients. Sudden onset of an inflamed joint can mimic a crystal arthropathy. The arthritis is often symmetrical, oligoarticular or polyarticular, and noneroziva nondeformanta.Ankles, elbows, interphalangeal joints, metacarpophalangeal and metatarsophalangeal are affected. Costochondritis joints can be involved, and sternomanubriale sternoclaviculare. Epansamentele can accompany arthritis.
Zaim nasalOccurs in 48-72% of patients. It is accompanied by acute pain and nasal sensation of fullness. There may be nosebleeds. The disease develops long nose deformation.
Ocular Inflammation:Collagen type II, IX, XI is described in the cornea and sclera.Autoantibodies to these types of collagen are responsible for direct damage. 50% of patients develop ocular sequelae associated with uveal tract inflammation Periodicals, conjunctivitis, scleritis and episclerita. Eyelid swelling, irritation and retinopathy are described in 9% of patients, while 5% have ocular muscle palsy or optic neuritis. Peripheral ulcerative keratitis is found in 4% of patients and is associated with perforation. Papiloedemul, visual field defects, ptosis, retraction, proptoza and cataracts are common.
Central nervous system:Cerebral manifestations are rare. They are caused by vasculitis.Patients may experience memory loss, hallucinations, muscle weakness, numbness.
Policondritei Complications include recurrent vertigo, tinnitus, joint deformation, hoarse voice, epiglottis, scleritis, conjunctivitis, iritis, traheotomiei need permanent, severe pulmonary infection, blindness, respiratory insufficiency, aortic regurgitation, mitral, aortic dissection, and glomerulonephritis.Evolution of recurrent policondritei:The most common cause of death associated with recurrent policondrita corticosteroid therapy include secondary infection and respiratory compromise, systemic vasculitis and neoplasms.Complications such as deformation policondritei nose, systemic vasculitis, laringotraheala stricture, arthritis and anemia in patients under 50 carries a negative prognosis. Renal impairment has a negative prognosis for all ages.

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