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What is the history of Relapsing Polychondritis?

When was Relapsing Polychondritis discovered? What is the story of this discovery? Was it coincidence or not?

History of Relapsing Polychondritis

Relapsing Polychondritis (RP): A Historical Overview



Relapsing Polychondritis (RP) is a rare autoimmune disease characterized by recurrent inflammation of cartilage throughout the body. First described in medical literature in the mid-20th century, RP has since been the subject of extensive research and clinical observations. Let's delve into the history of this intriguing condition.



Early Observations and Recognition:



The first documented case of RP dates back to 1923 when a French physician named Maurice Raynaud reported a patient with recurrent inflammation of the auricular cartilage. However, it wasn't until 1960 that the term "relapsing polychondritis" was coined by J. B. Hench, an American rheumatologist. Hench recognized the distinct clinical features of the disease and proposed the name to describe the recurrent nature of the condition and the involvement of multiple cartilaginous structures.



Advancements in Understanding:



Throughout the 20th century, researchers made significant strides in understanding the pathophysiology and clinical manifestations of RP. In the 1970s, it was established that RP is an autoimmune disorder, where the body's immune system mistakenly attacks its own cartilage. This breakthrough led to the development of diagnostic criteria and improved management strategies.



Diagnostic Criteria and Clinical Features:



The diagnostic criteria for RP were first proposed in 1986 by Damiani and Levine. These criteria include the presence of at least three of the following features: recurrent chondritis, ocular inflammation, audiovestibular damage, seronegative inflammatory arthritis, nasal chondritis, and respiratory tract chondritis. Fulfilling these criteria is crucial for accurate diagnosis and appropriate treatment.



Advances in Treatment:



Over the years, treatment options for RP have evolved, aiming to control inflammation and prevent cartilage damage. In the early stages, nonsteroidal anti-inflammatory drugs (NSAIDs) were commonly used to alleviate symptoms. However, as the understanding of RP improved, more targeted therapies were introduced.



Glucocorticoids:



Glucocorticoids, such as prednisone, have been the mainstay of treatment for RP. They effectively suppress inflammation and provide symptomatic relief. However, long-term use of glucocorticoids can lead to various side effects, necessitating the exploration of alternative therapies.



Immunosuppressive Agents:



Immunosuppressive agents, including methotrexate, azathioprine, and cyclophosphamide, have shown promise in managing RP. These medications help modulate the immune response and reduce the frequency and severity of relapses. They are often used in combination with glucocorticoids to achieve better disease control.



Biologic Therapies:



In recent years, the advent of biologic therapies has revolutionized the treatment of autoimmune diseases, including RP. Tumor necrosis factor (TNF) inhibitors, such as infliximab and etanercept, have demonstrated efficacy in controlling inflammation and preventing cartilage damage. Other biologics, such as rituximab and tocilizumab, have also shown promise in managing RP.



Ongoing Research and Future Directions:



Despite significant progress in understanding and managing RP, many aspects of the disease remain elusive. Ongoing research aims to unravel the underlying mechanisms of RP, identify novel therapeutic targets, and develop personalized treatment approaches.



Conclusion:



Relapsing Polychondritis has come a long way since its initial recognition in the early 20th century. From the early observations of auricular cartilage inflammation to the establishment of diagnostic criteria and the introduction of targeted therapies, the understanding and management of RP have significantly advanced. With ongoing research and advancements in treatment, the future holds promise for improved outcomes and a better quality of life for individuals living with RP.


Diseasemaps
10 answers
My understanding of RP is there is a vast amount of symptoms that are possible. Many different presentations of RP can appear. I heard back in the late 1920's a man was thought to have gotten RP from drinking too much beer! Of course we know know this is not true.

Posted Aug 14, 2017 by Susan 2000
No...I don't. That would be interesting.

Posted Sep 1, 2017 by Diane 2050
In 1923, Rudolf Jaksch von Wartenhorst first discovered Relapsing polychondritis while working in Prague and initially named it Polychondropathia.[17][18]

His patient was a 32-year-old male brewer who presented with fever, asymmetric polyarthritis, and the ears and nose showed signs of swelling, deformity and were painful. Biopsy of nasal cartilage revealed loss of the cartilage matrix and a hyperplastic mucous membrane. Jaksch von Wartenhorst considered this was an undescribed degenerative disorder of cartilage and named it Polychondropathia. He even took his patient's occupation into consideration, and related the cause to excessive alcohol intake.[18]

Since then, the disease has received many names. The following table shows the history of the nomenclature of Relapsing polychondritis. The current name, Relapsing Polychondritis (RP), was introduced by Pearson and his colleagues in 1960 to emphasize the episodic course of the disease.

Posted Mar 20, 2018 by Lisa Matthews (Lissy) 4800
Unknown I can not find when 1st patient diagnosed

Posted Jun 12, 2019 by Tmrcarlson 3550
The first clinical description of relapsing polychondritis was attributed to Jaksch-Wartenhorst, who in 1923 reported the case of a 32-year-old brewer with fever, asymmetric polyarthritis, and pain and swelling of his external ears.

Posted Jun 12, 2019 by Kaz 3000
(RP) is a rare disease of unknown etiology. The first clinical description of it is attributed to Jaksch-Wartenhorst, who in 1923 reported the case of a 32-year-old brewer with fever, asymmetric polyarthritis, and pain and swelling of his external ears.

Posted Dec 30, 2019 by Leanne 2500
The first case of RP was described in 1923 by Jaksch-Wartenhorst [1]. The term “relapsing polychondritis” was first used by Pearson et al. in 1960 in their review of 12 cases

Posted Dec 30, 2019 by Carrie 3050
It's rare, maybe 3 or 4 percent of the population. More may have contracted it but died before diagnosis. I did not seek medical help at first because I thought I had leprosy and would be separated from society. When my eye was affected, it became urgent, and I sought medical help.

Posted Mar 20, 2022 by shlawver 2500
Translated from spanish Improve translation
I have no idea of this story

Posted Oct 2, 2017 by Ana Luiza Bottura 2000

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The first time I noticed symptoms, I thought I was having an allergic reaction to something at work. My ears became so red and inflamed and hurt so bad. I let it go on for almost 3 days before finally going to a hospital where I was diagnosed with re...
Relapsing Polychondritis stories
It began with dry nose, nose bleeding and what my GP thought was a sinus infection. Antibiotics and prednisone perscribed, helped for a while, then reoccurred. Ear then swelled over twice the size - red, shiny and moist, GP again said outer ear infec...
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i had progressively worsening breathing issues for many years before my diagnosis of rp.  I went through many specialists and tests and no one could identify why I was having breathing issues.  I had no outward signs of rp until one day my ears swe...
Relapsing Polychondritis stories
I have had strange symptoms before this came to light, but during my last trimester of my pregnancy with my youngest son, I had a severe respiratory infection that never seemed to get better. I have had exercise induced asthma since I was young and t...
Relapsing Polychondritis stories
I was officially diagnosed with RP 2 yrs ago. No one else in my family has it. It started approximately 5 years ago with ear flares, jumping from one to the other. My PCP happened to go to a conference where RP was discussed, and soon contacted me to...

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I don't think RP is as rare as we are led to believe. It seems many symptoms are unrelated. You go to an ortho doc for knee/joint pain. You go to an ENT for ears and throat. You go to an ophthalmologist for eyes. You go to a dermatologist for skin. T...

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