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Diagnosed with relapsing polychondritis and have pain in chest. What should I do to avoid this?

Answered by
Dr.
Dr. Das Arindam

General & Family Physician

Practicing since :2008

Answered : 1416 Questions

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Posted on Thu, 22 Nov 2012 in General Health
Question: diagnosed with relapsing polychondritis. both ear cartilages are inflammated. all blood & urine tests including PR3 XXXXXXX IF and other relevant tests are normal and well within the biological limits. Ciproprofloxacin with ibuprofen and paracetmol has given great relief. Simultaneously i am also on homeopathic medicine. Also feeling slight pain in the chest area. ECG and other cardiac related tests are normal. Pls advise.
What should I do to avoid its recurring occurance.

YYYY@YYYY
doctor
Answered by Dr. Das Arindam 3 hours later
Hello Mr. XXXXXXX

Relapsing polychondritis is characterized by destruction of cartilage present in the body. Though cartilage is present in many parts, this disease mostly involves cartilages present in ear, nose, throat, rib cage and rarely heart valves also. This disease may leads to other diseases like vasculitis.
It is an autoimmune disease most probably caused by genetic predisposition, but cause is still unknown. Mainly affected patients are in 50's. It is fatal when it destroys tracheal cartilage leading to collapse of trachea and respiratory failure.

Here, in your case ear cartilages are involved first. But normal ECG and other cardiac tests indicate that heart valves are not involved. But chest pain indicates involvement of the costal cartilages of rib cages
Now, in diagnosis, C-Reactive protein and ESR are the best indicator of the disease progression which are not done. You should consult with your treating doctor for ordering these.
You have to follow the following instructions:
1. Take Nonsteroidal antiinflammatory drugs like diclofenac / paracetamol / ibuprofen group of drugs for pain.
2. You must take one pantoprazole group of medicine once daily in empty stomach.
3. If pain is not relieved by this, then corticosteroids are considered.
4. If it recurs then immunosuppressive drugs like methotrexate are indicated.
5. You should consult with a Rheumatologist for further investigation and management.
If you did not consulted a rheumatologist previously, you must do it now. Do not ignore it. Because it may aggravate anytime. So, be cautious. In my opinion, you should visit a teaching institute in your area, where all departments are under one roof.
Taking homeopathy is totally depends on you.

Basically, to prevent recurrence you have to take the abovementioned drugs after consulting rheumatologist. But, even after meticulous treatment, no guarantee can be given that it will not recur.

Hope this information suffices. Let me know, if you have any more question.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam 16 hours later
I have consulted rhematologists available at Hyderabad. Following is the prescription given. Please suggest me further or else connect me to a rhematalogist online for further consultation.

VITANOVA XXXXXXX 1 GM     Vit D     1 XXXXXXX / week mixing with milk for six weeks
ADAMAX CAPS          1 cap in morning
FULL - 365 CAPS          1 cap at night
HCQS TAB 200 MG          1 tab at night except Sunday
FOLINOL TAB 5 MG          1 tab at night except
MEXT 7.5 MG          1 tab in morning and 1 tab at night on sundays only
RABIFAST TAB 20 MG          1 tab at night
WYSOLONE 5 MG          1 tab in morning and 1/2 tab at night
DOLOWIN          1 tab in morning and 1 tab at night SOS

Regards
XXXXXXX
doctor
Answered by Dr. Das Arindam 1 hour later
Hello Mr. XXXXXXX
Thank you for writing back.

I have read the above prescription. It is the most appropriate treatment for your condition. Except those medicine, you need nothing at present.
Keep following up with the doctor.
I think you do not need to consult an online rheumatologist right now. In future, if you find no improvement in the disease condition, then you can take a second opinion from an online rheumatologist.

Take care.

If you have your answers close this discussion.
Rating and review given by you will be appreciated.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Das Arindam 44 hours later
I wanted to consult a XXXXXXX Rhemotologist to take second opinion. When I am getting good response with normal antibiotics and normal pain killers, Should I use corticosteriods and immuno suppressive drugs like predinislone and meothtrexate?????

I wish to have an answer from rhemotologist and not general medicine praticioners.
I am also using diabetici medicines like glycomet gp2 and 15 mg piaglitzone.. willit have any affect on sugar levels if i continue with corticosteriods and immuno suppressive drugs????
doctor
Answered by Dr. Das Arindam 3 hours later
Hello Mr. XXXXXXX

Firstly, pain killers and antibiotics will give you result for short time but these will not prevent the disease progression. To stop the disease progression, you have to take steroids and immunosuppressive agents. Because the main causative agent is your immune mechanism.

Secondly, if you want answer from a rheumatologist, then you have to mentioned it during posting the question.

In normal person, corticosteroids increase the blood sugar level mildly. Incase of diabetics, dose of antidiabetic agents should be changed after monitoring the blood sugar level if required.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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