Anesthetic experience of a patient with relapsing polychondritis -A case report-

Kim, Inki; Kim, Min Soo; Choi, Yong Seon; Shin, Yong Sam

doi:10.4097/kjae.2012.63.5.465

Cited by 6 publications

(3 citation statements)

References 13 publications

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“… 38 Cerebral MRI may be useful if central nervous system involvement is suspected. 39 Otorhinolaryngoscopic examination reveals conductive and sensorineural hearing loss in about 40% of cases, sometimes along with nasal ulcerations, septal perforations, saddle nose deformity, arytenoid swelling and vocal cords deformities. 13 Pulmonary spirometry, including inspiratory volumes, may help assess the tracheal involvement.…”

Section: Resultsmentioning

confidence: 99%

Relapsing polychondritis: state of the art on clinical practice guidelines

Rednic

Damian

Talarico³

et al. 2018

RMD Open

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Due to the rarity of relapsing polychondritis (RP), many unmet needs remain in the management of RP. Here, we present a systematic review of clinical practice guidelines (CPGs) published for RP, as well as a list of the most striking unmet needs for this rare disease. We carried out a systematic search in PubMed and Embase based on controlled terms (medical subject headings and Emtree) and keywords of the disease and publication type (CPGs). The systematic literature review identified 20 citations, among which no CPGs could be identified. We identified 11 main areas with unmet needs in the field of RP: the diagnosis strategy for RP; the therapeutic management of RP; the management of pregnancy in RP; the management of the disease in specific age groups (for instance in paediatric-onset RP); the evaluation of adherence to treatment; the follow-up of patients with RP, including the frequency of screening for the potential complications and the optimal imaging tools for each involved region; perioperative and anaesthetic management (due to tracheal involvement); risk of neoplasms in RP, including haematological malignancies; the prevention and management of infections; tools for assessment of disease activity and damage; and patient-reported outcomes and quality of life indicators. Patients and physicians should work together within the frame of the ReCONNET network to derive valuable evidence for obtaining literature-informed CPGs.

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Section: Resultsmentioning

confidence: 99%

Relapsing polychondritis: state of the art on clinical practice guidelines

Rednic

Damian

Talarico³

et al. 2018

RMD Open

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show abstract

“…Management of RP in pregnant women is complex and must be conducted by a multidisciplinary team throughout the process, consisting of obstetricians, anaesthesiologists, rheumatologists, and pulmonologists, in order to ensure adequate planning for potential complications [10]. The degree of respiratory and cardiovascular compromise should be well investigated and documented prior to pregnancy [1,2].…”

Section: Discussionmentioning

confidence: 99%

Management of preeclampsia with severe features in a patient with relapsing polychondritis affecting the tracheobronchial tree

Martín‐Serrano,

Sarrió‐Badenes,

Durá‐Aranda

et al. 2023

Anaesthesia Reports

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SummaryRelapsing polychondritis is a rare disease that affects cartilaginous structures throughout the body. Progressive destruction of the laryngeal structures and the tracheobronchial tree occurs in 50% of patients, potentially leading to loss of patency and collapse of the airway. Respiratory involvement in relapsing polychondritis includes airway stenosis, tracheomalacia and recurrent lung infections due to chronic inflammation caused by the destruction of upper and lower airway cartilage. Pregnancy and preeclampsia can worsen pharyngolaryngeal oedema, while treatment with magnesium sulphate can affect neuromuscular function, exacerbating the degree of airway collapse in the most serious cases of relapsing polychondritis, possibly altering obstetric outcomes. Here, we present the management of a pregnant woman with relapsing polychondritis who presented with features of severe preeclampsia at 29 weeks and 6 days gestation. We believe that this is the first published case of the combination of the two disorders, complicated by acute respiratory failure after treatment with magnesium sulphate.

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“…Because RP is a rare autoimmune disorder, with an incidence of 3.4–4.5 cases per million per year [ 2 ], it is also uncommon to see these patients for anesthesia. Sometimes, regional anesthesia is used to avoid difficulties surrounding airway management [ 10 ]. When general anesthesia is necessary, cautious airway management is needed [ 11 ], or an oxygen supply should be guaranteed by extracorporeal membrane oxygenation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report

et al. 2022

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Relapsing polychondritis (RP) is a rare autoimmune disorder that causes inflammation and deterioration of cartilaginous structures such as the ears, nose, joints and laryngotracheobronchial tree. A 42-year-old man receiving treatment for RP underwent open reduction and internal fixation of a femur fracture under spinal anesthesia and with sedation by propofol and remifentanil. The level of sedation was monitored via a bispectral index (BIS), and maintained at between 60 and 80. At the end of the operation, he lost consciousness and displayed weak respiratory effort. During mask ventilation, the patient was judged to have respiratory failure due to high end-tidal CO2 (EtCO2) concentration and respiratory acidosis in an arterial-blood-gas analysis (ABGA). Ventilation through a properly inserted laryngeal-mask-airway or endotracheal intubation were impossible; instead, a surgical tracheotomy was performed. After recovering from respiratory failure with ventilatory support in the intensive care unit (ICU), he experienced the same symptoms three more times, requiring ventilatory support. He was discharged with bilevel positive-airway-pressure (BiPAP), after successful adaptation.

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Anesthetic experience of a patient with relapsing polychondritis -A case report-

Cited by 6 publications

References 13 publications

Relapsing polychondritis: state of the art on clinical practice guidelines

Relapsing polychondritis: state of the art on clinical practice guidelines

Management of preeclampsia with severe features in a patient with relapsing polychondritis affecting the tracheobronchial tree

Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report

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