Examination of recurrent polychondritis

The main manifestations are orthochromatic anemia, significantly increased white blood cell count, thrombocytosis, eosinophilia, accelerated erythrocyte sedimentation rate, hypoalbuminemia, gammaglobulinemia and hematocrit.

2. Serological examination

Rheumatoid factor and antinuclear antibody were positive. False positive serological reaction of syphilis. Circulating immune complexes are also usually positive. Indirect fluorescence immunoassay showed that anti-cartilage antibody and anti-natural collagen II antibody were generally positive in active phase, but they could turn negative after hormone treatment. Therefore, the positive antibody against natural type ⅱ collagen may contribute to the diagnosis of RP. Uric acid mucopolysaccharide is positive, which can be 4.2 1 times higher than the normal value at the time of onset, which can indicate the degree of cartilage destruction.

3. Auxiliary inspection

(1)X-ray examination, atelectasis, pneumonia. Tracheobronchial section shows that tracheobronchus is generally narrow, especially when the arm is extended backward and the chest is extended forward, which can show local collapse of trachea. At the same time, it can also show that the aortic arch is gradually enlarged, and the ascending aorta, descending aorta, auricle, nose, trachea and larynx are calcified. X-ray of peripheral joints showed that the bone density near the joints decreased, and occasionally the joint cavity gradually narrowed, but there was no invasive damage. The spine is generally normal, and a few reports have serious kyphosis, joint cavity stenosis, lumbar and intervertebral disc invasion and fusion changes. The pubic bone and sacroiliac joint are partially occluded and irregularly invaded.

(2) The degree and scope of tracheal and bronchial tree stenosis, thickening and calcification of tracheal and bronchial walls, stenosis and deformation of lumen, and mediastinal lymphadenopathy; 2)CT examination. End-expiratory CT scan can observe the degree of airway collapse. High-resolution CT can show the inflammation of segmental bronchi and pulmonary lobules.

(3) Echocardiography can find ascending aortic aneurysm or descending aortic aneurysm, pericarditis, impaired myocardial contraction, mitral or tricuspid regurgitation, atrial thrombosis, etc. Electrocardiogram can appear I degree or complete atrioventricular block.

(4) Fiberoptic bronchoscope can directly observe the affected airway, show the inflammation, deformation and collapse of tracheobronchial tree, and further diagnose and observe the disease process.

(5) The pulmonary function test shows that there is obstruction in both exhalation and inhalation by measuring the inspiratory and expiratory flow curves. By analyzing the velocity-volume curve, the maximum expiratory velocity and maximum inspiratory velocity at 50% vital capacity can be obtained, and the proportion of fixed stenosis and variable stenosis in dyspnea can be distinguished, and the position of stenosis can be judged.

(6) Biopsy can provide further diagnostic basis, but if the clinical symptoms are typical, it is not necessary to biopsy. The biopsy site can be nasal cartilage, airway cartilage, auricle cartilage, etc. However, after biopsy, recurrent polychondritis may occur, resulting in new deformities. Therefore, special attention should be paid to the removal of auricular cartilage behind the ear.