Comment on: Aortarctia: a rare manifestation of relapsing polychondritis: reply
Comment on: Aortarctia: a rare manifestation of relapsing polychondritis: reply
复制标题
评论：主动脉：复发性多软骨炎的罕见表现：回复
DOI：
10.1093/rheumatology/keaa124
复制
发表时间：
2020
期刊：
影响因子：
5.5
通讯作者：
Hang Pan
中科院分区：
文献类型：
--
作者：
Lin Tang;Feifeng Ren;Wenhan Huang;Jun Zhou;Dongmei Huang;Lei Luo;Hang Pan
SIR, We read the report by Shirai et al.[1] about a patient in the very early phase of relapsing polychondritis (RP) complicated with aortitis, suggesting that the clinical background of such patients is versatile and inflammation is more intense in large vessels than in cartilage [1]. Here we would like to provide more understanding of cardiovascular involvement in RP [2]. RP is a rare systemic autoimmune disease characterized by recurrent inflammation and destruction of cartilaginous structures including eyes, pinna, nose, tracheobronchial airways, joints, blood vessels and cardiac valves. Cardiovascular involvement in RP is presented in two ways: cardiovascular damage induced by RP and cardiovascular damage induced by RP complicated with other diseases. On the one hand, cardiovascular damage is secondary to RP. Cardiovascular complications appear in about 25 30% of patients with RP, including aortic aneurysm, aortic dissection, artery stenosis, aortic and mitral regurgitation/insufficiency, myocarditis, and pericarditis, among which aortic or mitral regurgitation and aortic aneurysm account for the most. If RP presents cardiovascular involvement, differential diagnosis of other systemic vasculitis, such as Takayasu arteritis (TAK) and Behcet’s disease (BD) should be made. In our clinical vignette, we reported RP complicated with arthritis, scleritis, severe mitral insufficiencies, discordant blood pressure, perforating ulcer, and stenosis of the aortaventralis and left subclavian artery. Although discordant blood pressure, perforating ulcer, and stenosis of the aortaventralis and left subclavian artery occur in TAK, the severe mitral insufficiency is very rare in TAK. TAK injures aortic valve frequently, instead of mitral valve. RP and BD share an unusual predilection for the development of stenosis and
