Policondrita appellant - Diagnosis and treatment

Laboratory studies:-If this is norocroma anemia and normocytic, associated with negative prognosisEasy-leukocytosis-ESR, high protein C-Evaluation of antinuclear antibodies, antiphospholipid, rheumatoid factor-Assessment of creatinine, liver transaminases, serum alkaline phosphatase, cryoglobulinsSputum-culture of cartilage biopsies, blood cultures.
Imaging Studies:Radiograph showed tracheal stenosis, calcification of cartilage structures, suggesting parenchymal lung infiltrates, vasculitis.CT scan is noninvasive and identifies tracheal and bronchial cartilage thickening, stenosis and calcification.MRI is useful in differentiating between edema, fibrosis and inflammation.Testing lung function and respiratory volumes is recommended in patients with symptoms of obstructive respiratory failure and shows character.Histological examination: biopsy of cartilage from patients with recurrent policondrita, chondrita and demonstrates pericondrita condroliza. The cartilage loses its basophilia by releasing matrix proteoglycans and chondrocytes are diminished in number and appear pyknotic. The disease is characterized by mixed inflammatory infiltrate of lymphocytes, neutrophils and plasma cells in pericondrum. As the cartilage degenerates macrophages and monocytes infiltrate the matrix. Reinlocuita cartilage matrix is ​​destroyed and fibrous connective tissue.The differential diagnosis is made with the following diseases: Addison's disease, Bechcet disease, cellulite, hyperthyroidism, polyarteritis nodosum, rheumatoid arthritis, lupus erythematosus, Wegener's granulomatosis, pericondrita infection, trauma, congenital syphilis, chronic otitis externa.
Treatment
Treatment of the symptoms and trying to preserve the structure of cartilage. Corticosteroid regimens with prednisone is administered in the acute phase. severe acute need high doses of prednisone. Most patients require a small daily dose of prednisone for maintenance. Other drugs reported to control symptoms and disease progression include dapsone, azathioprine, methotrexate, cyclophosphamide and cyclosporin. Treatment with TNF-alpha inhibitors: infliximab, etanercept, adalimumab shows success.Policondrita surgical techniques used include tracheostomy, Tracheotomy permanent stent placement, aortic aneurysm repair, aortic valve reinlocuirea and rhinoplasty.