Elucidation of predictors of disease progression in patients with relapsing polychondritis at the onset: potential impact on patient monitoring

Abstract Background In patients with relapsing polychondritis (RP), organ involvement developed in those with progressive and/or long disease courses. For their management, elucidation of a subgroup suggesting disease progression is awaited. Methods We previously conducted a physician’s questionnaire-based retrospective study to elucidate major clinical features of Japanese patients with RP. We here evaluated organ involvement at disease onset and at the last follow-up. We then counted cumulative numbers of involved organs at the last follow-up in 229 RP patients and compared them with involved organ numbers at disease onset, as possible indicators of disease progression. We assigned their prognosis at the last follow-up into “patient prognostic stages” from no medication (stage 1) to death (stage 5). We utilized nonparametric tests for group comparisons. Results Involved organ numbers per-patient were 1.13 ± 0.03 at disease onset and 3.25 ± 0.10 at the last follow-up (disease duration was 4.69 ± 0.33 years), and increased along with the patient prognostic stages. At disease onset, 135 and 48 patients had auricular involvement (59% of 229 patients, defined as auricular-onset subgroup; AO) and respiratory involvement (21%, respiratory-onset subgroup; RO), respectively. 46 patients presented with other conditions (20%, miscellaneous-onset subgroup; MO) including CNS, ocular, and inner ear involvement, among others. RO patients showed worse (poorer) prognostic stages than AO patients. MO patients developed respiratory and/or auricular involvement thereafter and then showed significantly higher mortality rate (15%; 7/46) than AO patients (5.9%; 8/135). In RP patients who did not develop respiratory involvement until the last follow-up (throughout the disease course; 117 patients), mortality rate was 19% in 26 MO patients and 3.3% in 91 AO patients. Accordingly, RO patients and MO patients associated with relatively poor prognosis compared with AO patients. Conclusions Allocation of patients to RO and MO subgroups was suggested to associate with poorer prognosis of RP than AO subgroups, especially AO subgroups without respiratory involvement throughout. All RP patients deserve careful monitoring but special attention should be paid to MO patients because of their diverse and accelerated disease progression.

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Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01861-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lei Zhang ◽

Shuang Yun ◽

Tiange Wu ◽

Yujie He ◽

Jinyan Guo ◽

...

Keyword(s):

Early Recognition ◽

Age At Onset ◽

Relapsing Polychondritis ◽

Organ Involvement ◽

Strong Negative Correlation ◽

Negative Pattern ◽

Inflammatory Status ◽

Clinical Patterns ◽

Systemic Form

Abstract Background Relapsing polychondritis (RPC) is a rare autoimmune disease and its early diagnosis remains challenging. Defining the clinical patterns and disease course may help early recognition of RPC. Results Sixty-six males and 60 females were included in this study. The average age at onset were 47.1 ± 13.8 years and the median follow-up period was 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r = − 0.75, P < 0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%), and patients with Ear pattern and Airway pattern were further divided into limited and systemic form of RPC (27.8% with limited form of Ear pattern and 24.6% with limited form of Airway pattern initially). During follow-up, a minority of patients with Ear pattern and Airway pattern progressed into Overlap pattern, and some Airway-Ear negative pattern patients progressed into Ear pattern. While a large majority of limited RPC patients remained limited form during follow-up, a minority of limited RPC patients progressed into systemic form. Patients with Ear pattern had the highest survival rate and relatively lower inflammatory status. Conclusions RPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement. The clinical patterns and presenting forms may evolve during follow-up. Our findings may facilitate early recognition of this rare disease.

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749 Clinical profile and outcome of patients with Anderson–Fabry disease followed at a multidisciplinary cardiomyopathy centre

European Heart Journal Supplements ◽

10.1093/eurheartj/suab142.016 ◽

2021 ◽

Vol 23 (Supplement_G) ◽

Author(s):

Federica Verrillo ◽

Carlo Fumagalli ◽

Luigi Tassetti ◽

Chiara Zocchi ◽

Ilaria Tanini ◽

...

Keyword(s):

Kidney Disease ◽

Fabry Disease ◽

Disease Progression ◽

De Novo ◽

Left Ventricular ◽

Age At Diagnosis ◽

Organ Involvement ◽

Enzyme Replacement ◽

Progression Of Kidney Disease

Abstract Aims Anderson–Fabry disease (AFD) is a rare genetic lysosomal storage disorder which often goes unnoticed until the onset of symptoms requires aggressive treatment. Prompt diagnosis remains crucial. Dedicated centres may offer a remarkable opportunity to develop early detection strategies and prompt appropriate multidisciplinary management. To describe the long-term outcomes of patients diagnosed with AFD followed at a national Cardiomyopathy Referral Center according to phenotype (clinical involvement vs. sub-clinical involvement). Methods and results Consecutive patients visited at our Cardiomyopathy Unit from 1989 to 2020 with >1-year follow-up were retrospectively reviewed. Clinical involvement was defined by the presence of one among left ventricular hypertrophy (LVH)>15 mm, presence of conduction blocks or cardiac implantable electronic devices (CIED), atrial fibrillation, kidney disease (glomerular filtration rate <60 ml/min/m2, dialysis or kidney transplant), stroke or transient ischaemic attack (TIA). Disease progression was defined by either de novo CIED implantation, de novo LVH > 15mm or increased IVS, de novo Stroke/TIA, or progression of kidney disease. Overall, 110 were diagnosed with AFD [first via α galactosidase (αGAL) activity and then confirmed via genetic exam], and 86 (78%) with >1-year follow-up were selected. Clinical involvement was present in 60 (70%) patients. Age at diagnosis was similar between patients with clinical and subclinical phenotype (42 ± 17 vs. 39 ± 15, P = 0.277). Patients manifesting clinical involvement compatible with AFD were more frequently men [N = 25 (42%) vs. 4 (15%), P = 0.025] and probands (P = 0.01). Overall, one organ involvement was present in 31 (52%) patients, two organ involvement in 24 (40%) patients, and three organs in 5 (8%). A total of 46 (77%) patients were referred for enzyme replacement therapy (ERT): 52% received agalsidase α, 26% agalsidase β, and 22% migalastat. Among those with a clinical involvement not on ERT, nine (15%) were scheduled for ERT initiation, three (5%) were considered old for ERT, one (1.5%) refused ERT, and one (1.5%) had an allergic reaction to ERT. At 7 (3–12) years follow-up, both study cohorts manifested signs and symptoms of disease progression, although its incidence was higher in patients with clinical involvement [N = 28 (47%, 4.7%/year) vs. N = 4 (15%, 1.5%/year), in clinical vs. subclinical involvement, respectively, P = 0.01]. The main causes for diseases progression were increase in LVH (28%), de novo LVH (13%), progression of kidney disease (7%), and CIED implantation (5%). All patients with disease progression in the subclinical involvement group had been diagnosed with family screening; among these, two were men and one had a late onset phenotype. Three developed LVH > 15mm and one kidney disease. Conclusions Clinical involvement in AFD is frequent irrespective of age at diagnosis, being present in more than 1-in-2 patients at baseline. Prompt referral to dedicated centres is warranted for appropriate care as disease may progress in both patients with and without initial clinical involvement despite optimal medical management.

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Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study

10.21203/rs.3.rs-22652/v1 ◽

2020 ◽

Author(s):

Lei Zhang ◽

Shuang Yun ◽

Tiange Wu ◽

Yujie He ◽

Jinyan Guo ◽

...

Keyword(s):

Rare Disease ◽

Early Recognition ◽

Relapsing Polychondritis ◽

Organ Involvement ◽

Disease Evolution ◽

Negative Pattern ◽

Inflammatory Status ◽

Clinical Patterns ◽

Systemic Form

Abstract BackgroundRelapsing polychondritis(RPC) is a rare autoimmune disease, of which the diagnosis in early stage is challenging. Defining the clinical patterns and disease evolution may help early recognition of this rare disease.ResultsSixty-six males and 60 females were included with onset age of 47.1±13.8 years and followed up for a median of 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r=-0.75，P<0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%) and patients with Ear pattern and Airway pattern were subdivided as limited and systemic form of RPC (27.8% with limited form of Ear pattern and 24.6% with limited form of Airway pattern). During follow-up, a small part of patients with Ear pattern and Airway pattern progressed into Overlap pattern and some Airway-Ear negative pattern patients progressed into Ear pattern. Most of the limited RPC patients remained limited form during follow-up while some patients with limited form progressed into systemic form. Patients with Ear pattern had the highest survival rate and relative lower inflammatory status.ConclusionsRPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement, and clinical patterns and presenting forms can evolve during follow-up. Our findings may facilitate early recognition of this rare disease and contribute to an updated classification criteria covering all the clinical spectrum of RPC

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Prognostic value of 1q21 amplification in multiple myeloma

Terapevticheskii arkhiv ◽

10.17116/terarkh201789732-38 ◽

2017 ◽

Vol 89 (7) ◽

pp. 32-38 ◽

Cited By ~ 4

Author(s):

T V Abramova ◽

T N Obukhova ◽

L P Mendeleeva ◽

O S Pokrovskaya ◽

E O Gribanova ◽

...

Keyword(s):

Multiple Myeloma ◽

Survival Rate ◽

Disease Progression ◽

Chromosomal Abnormalities ◽

Disease Onset ◽

Clinical Manifestations ◽

Diagnostic Study ◽

Extra Copy ◽

Course Of Disease

Aim. To determine the prevalence of amp1q21 and its relationship to the clinical manifestations of multiple myeloma (MM). Subjects and methods. In December 2009 to March 2016, a total 134 patients aged 30 to 81 years (median 57 years) underwent a pretreatment FISH-study of bone marrow (BM) with centromeric and locus-specific DNA probes to identify amp1q21, t(11;14), t(4;14), t(14;16), t(14;20), t(6;14), trisomies of chromosomes 5, 9, 15, del13q14, del17p13/TP53, and t(8q24)/cMYC. Induction therapy with bortezomib-containing cycles was performed. Autologous stem cell transplantation was carried out in 48 patients. The median follow-up of patients was 19.3 months (3.2—77.4 months). Disease progression was diagnosed in 69 (51.5%) patients; 12 patients also underwent FISH study during disease progression. Results. At the onset of MM, amp1q21 was detected in 53 (39.6%) patients. The overall 5-year survival rate in patients with amp1q21 was almost 2 times lower than that in those without amp1q21 (43.5 and 79.4%, respectively; p=0.07). The overall 5-year survival rate in patients with one extra copy of 1q21 (only 3 copies) was 67.3%, that in those with 2 or more extra copies of 1q21 (only 4—7 copies) was 20.9% (p=0.0016). Nine (75%) of the 12 patients examined during disease progression were found to have amp1q21: 2 cases were detected in the period of progression to have amp1q21 in its absence at disease onset; 7 cases had amp1q21 both at MM onset and progression; however, the number of copies of 1q21 was unchanged. Conclusion. Аmp1q21 is one of the most common chromosomal abnormalities in patients with new-onset MM and may appear in the course of disease progression. The presence of аmp1q21 is an important prognostic factor and must have to be included in the diagnostic study both at disease onset and progression.

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Early Mortality in 1000 Newly Diagnosed MDS Patients with Low- and Intermediate-1 Risk MDS in the European Leukemianet MDS (EUMDS) Registry

Blood ◽

10.1182/blood.v120.21.3830.3830 ◽

2012 ◽

Vol 120 (21) ◽

pp. 3830-3830 ◽

Cited By ~ 5

Author(s):

Louise de Swart ◽

Alex Smith ◽

Pierre Fenaux ◽

Guillermo Sanz ◽

Eva Hellstrom-Lindberg ◽

...

Keyword(s):

Mortality Rate ◽

Disease Progression ◽

Conflicts Of Interest ◽

Clinical Signs ◽

Specific Treatment ◽

Great Majority ◽

Early Mortality ◽

Newly Diagnosed ◽

Point Of Interest

Abstract Abstract 3830 Background: The EUMDS registry was established to obtain an overview in the real world MDS demographics, diagnostics and disease-management. From April 2008 until December 2010, 1000 newly diagnosed patients with IPSS low and int-1 risk MDS were included in 14 countries and 118 participating centers. The major clinical problems in MDS are the consequences of cytopenias and disease-progression. Therefore, the most important treatment goals are improvement of cytopenias and prevention of leukemia. Objectives: To describe the causes of early mortality and to analyze the outcome of the first 1000 patients in the registry with and without disease-progression at 24 months follow-up. Results: The median age of the population was 74 years (range 18–95), 60% were male. The most frequent co-morbidities were hypertension (46%), diabetes mellitus (18%), arrhythmias (12%), and thyroid diseases (12%). The WHO subgroups are RCMD (39%), RA (19%), RARS (17%), RAEB-1 (13%), RCMD-RS (7%), MDS-U (3%), and del5q (2%). IPSS score (n=935) was 0 in 48%, 0.5 in 31% and 1 in 14% of the patients. WPSS score (n=924) was Very Low in 32%, Low in 38%, Intermediate in 19% and High in 4% of the patients (Table1). 184 of 1000 patients (18%) had started MDS specific treatment within 3 months after diagnosis: this increased to 43% at 24 months of follow-up. 15% of the patients (in 12 of the 14 countries) started ESA treatment at registration and this increased to 31% at 24 months, combined with G-CSF in 7%. At registration, 29% of the patients had received at least one RBC transfusion with a mean pre-transfusion Hb level of 8 g/dL. The percentage of transfusion-dependent (TD) patients remained stable during follow-up with 31%, 29%, 26% and 29% at 6, 12, 18, 24 months of follow-up, respectively. At 24 months, overall survival (OS) is 83%. Median time from date of inclusion until progression to higher risk MDS or leukemia is 293 days. Most patients (123) have died without disease-progression (DP) versus 45 patients who have died after DP at 24 months (Table1). DP has been defined as an increase in bone marrow blasts to a higher WHO category. The main causes of death in patients without DP were infections (21%) and cardiovascular events (11%). The mortality rate in transfusion-independent (TI) and TD patients without DP was 5% and 24%, respectively. In TI and TD patients with DP, the mortality rate was 32% and 66%, respectively (Table1; Graph 1). To define the prognostic relevance of serum ferritin (SF) and TD, the SF levels divided in two groups (1. <1000 μg/L, 2. ≥1000 μg/L) were compared in TI and TD patients and stratified by disease-progression. The mortality rate according to SF at registration in TI patients without DP was 9% and 13%, respectively (HR 1.61, 95%CI 0.49–5.37). The mortality rate according to SF at registration in TD patients without DP was 21% and 56%, respectively (HR 4.79, 95%CI 2.56–8.96) (Table 1). Conclusions: The great majority of deceased lower risk MDS patients have died before they have developed clinical signs of disease-progression. Transfusion-dependent patients without disease-progression have a four times higher mortality rate than transfusion-independent patients. This indicates that the pathophysiology of cytopenias and related complications are a major point of interest in early mortality, especially in patients without disease-progression. Disclosures: No relevant conflicts of interest to declare.

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Comparison of the Phenotype and Outcome of Granulomatosis with Polyangiitis Between UK and Japanese Cohorts

The Journal of Rheumatology ◽

10.3899/jrheum.160005 ◽

2016 ◽

Vol 44 (2) ◽

pp. 216-222 ◽

Cited By ~ 17

Author(s):

Shunsuke Furuta ◽

Afzal N. Chaudhry ◽

Yoshihiro Arimura ◽

Hiroaki Dobashi ◽

Shouichi Fujimoto ◽

...

Keyword(s):

United Kingdom ◽

Granulomatosis With Polyangiitis ◽

Age At Onset ◽

Survival Rates ◽

Disease Onset ◽

Japanese Patients ◽

Antineutrophil Cytoplasmic Antibodies ◽

Respiratory Involvement ◽

The United Kingdom ◽

The Uk

Objective.There are differences in the frequencies of antineutrophil cytoplasmic antibodies (ANCA)–associated vasculitis subgroups between different geographic regions, and we have reported differences in the phenotype of microscopic polyangiitis between Europe and Japan. In this retrospective observational study, we compared phenotypes and outcomes of granulomatosis with polyangiitis (GPA) between the United Kingdom and Japan.Methods.We identified 128 UK and 82 Japanese patients with GPA diagnosed between 2000 and 2012. We evaluated baseline characteristics including ANCA status and organ involvement, treatment, patient and renal survival, and time to first relapse.Results.Median age at onset was higher in Japan than in the UK (62.2 yrs vs 57.5 yrs, p < 0.01). The proportion of patients with proteinase 3 (PR3)-ANCA was lower in Japan than in the UK (61.0% vs 85.2%, p < 0.01), while the proportion of myeloperoxidase-ANCA was higher in Japan than the UK (34.1% vs 8.6%, p < 0.01). Serum creatinine at diagnosis was lower in Japan than the UK (68.1 μmol/l vs 101.0 μmol/l, p < 0.01). Respiratory involvement was more frequent in Japan than the UK (69.5% vs 40.6%, p < 0.01). In both countries, most patients received both glucocorticoids and cyclophosphamide. At 60 months the cumulative survival rates were 87.6% and 94.3% in Japan and the UK, respectively (p = 0.03). At 60 months the cumulative relapse rates were 37.1% and 68.1% in Japan and the UK, respectively (p < 0.01).Conclusion.Japanese patients with GPA were older at disease onset, with less PR3-ANCA positivity, milder renal dysfunction, and more frequent respiratory involvement than UK patients. The relapse-free survival rate was higher in Japan than the United Kingdom.

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Polymorphisms of apolipoprotein E and Japanese patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458503ms934oa ◽

2003 ◽

Vol 9 (4) ◽

pp. 382-386 ◽

Cited By ~ 19

Author(s):

M Niino ◽

S Kikuchi ◽

T Fukazawa ◽

I Yabe ◽

K Tashiro

Keyword(s):

Multiple Sclerosis ◽

Disease Progression ◽

Gene Polymorphisms ◽

Disease Onset ◽

Japanese Patients ◽

E Gene ◽

Apolipoprotein A ◽

Apo E ◽

Ε4 Allele ◽

Allele Positivity

The relation between apolipoprotein (A PO E) gene polymorphisms and disease progression of multiple sclerosis (MS) is controversial. The present study was designed to investigate the relation between A PO E gene polymorphisms and Japanese patients with MS. We analysed the frequencies of A PO E gene polymorphisms in 135 MS patients and 134 healthy controls, using PC R-RFLP. The results showed no significant differences in the distribution of A PO E gene polymorphisms between MS patients and controls. With regard to disease progression, there was no association between A PO E gene polymorphisms and ε4 allele positivity and disease progression index (EDSS/years). Furthermore, in patients with more than 10 years of disease onset, there were no significant differences between the frequencies of ε4 allele and patients with EDSS of more than 6. A lthough the low rate of ε4 allele in Japan should be taken into consideration, our results showed no relation between APO E gene polymorphisms and Japanese patients with MS.

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Epilepsy as a predictor of disease progression in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/13524585211046739 ◽

2021 ◽

pp. 135245852110467

Author(s):

Matthias Grothe ◽

David Ellenberger ◽

Felix von Podewils ◽

Alexander Stahmann ◽

Paulus S Rommer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Disease Progression ◽

Disease Onset ◽

Walking Distance ◽

Disability Status ◽

Cortical Pathology ◽

Underlying Mechanisms ◽

Patients With Epilepsy

Background: Epilepsy development during the course of multiple sclerosis (MS) is considered to be the result of cortical pathology. However, no long-term data exist on whether epilepsy in MS also leads to increasing disability over time. Objective: To examine if epilepsy leads to more rapid disease progression. Methods: We analyzed the data of 31,052 patients on the German Multiple Sclerosis Register in a case–control study. Results: Secondary progressive disease course (odds ratio (OR) = 2.23), age (OR = 1.12 per 10 years), and disability (OR = 1.29 per Expanded Disability Status Scale (EDSS) point) were associated with the 5-year prevalence of epilepsy. Patients who developed epilepsy during the course of the disease had a higher EDSS score at disease onset compared to matched control patients (EDSS 2.0 vs 1.5), progressed faster in each dimension, and consequently showed higher disability (EDSS 4.4 vs 3.4) and lower employment status (40% vs 65%) at final follow-up. After 15 years of MS, 64% of patients without compared to 54% of patients with epilepsy were not severely limited in walking distance. Conclusion: This work highlights the association of epilepsy on disability progression in MS, and the need for additional data to further clarify the underlying mechanisms.

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Clinical characteristics and disease patterns of patients with relapsing polychondritis: a retrospective cohort

10.21203/rs.3.rs-1215228/v1 ◽

2021 ◽

Author(s):

Dong Wang ◽

Lujia Guan ◽

xin Dong ◽

Xiaofan Zhu ◽

Zhaohui Tong

Keyword(s):

Retrospective Cohort ◽

Pulmonary Infection ◽

Activity Index ◽

Relapsing Polychondritis ◽

Disease Activity Index ◽

Chest Ct ◽

Ocular Involvement ◽

Respiratory Involvement ◽

Disease Patterns

Abstract Background Relapsing polychondritis (RP) is a rare autoimmune disease affected various cartilage, Patients with tracheal cartilage involvement are different from other patients. The objectives of this study were to allocated RP patients into two subgroups by chest computed tomography (CT) and compare the clinical features and disease patterns of each group.Methods A retrospective cohort study collected RP patients hospitalized at the Beijing Chao-Yang Hospital between January 2012 - August 2021. Patients were divided into two groups: respiratory involvement group and non-respiratory involvement group according to chest CT.Results In our study, respiratory involvement found in 59.7% (n=43) patients, which had higher rate of costochondritis, fewer rate of Inflammatory eye disease and auricular chondritis than those in non-respiratory involvement. Compared with non-respiratory involvement subgroup, The incidence of pulmonary infection marginally increased and those inflammatory indexes except for CAR were significantly higher in respiratory involvement subgroup, further subgroup analysis found that there was no significant relationship between inflammatory indexes and pulmonary infection. Finally, 5 patients died during the follow-up in this cohort with a median follow-up time of 6 years (range 3-8 years).Conclusion 59.7% of patients had respiratory involvement according to chest CT findings in our cohort, which had a strong inverse relationship between respiratory and auricular, ocular involvement. Increase inflammatory indexes were not correlated with pulmonary infection, suggesting that patients with respiratory involvement had a higher disease activity index of RP. The probability of survival was not found significant in two subgroups.

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Can Mechanical Injury Really Trigger Relapsing Polychondritis? The First Report From A Large Case Series

10.21203/rs.3.rs-78066/v1 ◽

2020 ◽

Author(s):

Lei Zhang ◽

Shuang Yun ◽

Tiange Wu ◽

Yujie He ◽

Jinyan Guo ◽

...

Keyword(s):

Mortality Rate ◽

Disease Onset ◽

Clinical Manifestations ◽

Case Series ◽

Relapsing Polychondritis ◽

Female Gender ◽

Auricular Chondritis ◽

History Of ◽

Large Case Series ◽

One Year

Abstract Objectives The triggers of relapsing polychondritis (RPC) are not fully characterized. This study was performed to explore the association between mechanical injuries and RPC.Methods The history of mechanical injuries of 127 RPC patients was reviewed and confirmed. The characteristics and survivals of patients with mechanical injuries were analyzed. Results Fifty-four patients (42.5%) had 63 mechanical injuries, among which 17 were cartilage-related. Thirty mechanical injuries in 28 patients occurred in the preceding one year before disease onset. Patients with mechanical injuries(n=54) had a higher proportion of female gender (59.3% vs 38.4%, P=0.002) and similar features compared to those without injuries(n=73), regarding clinical manifestations and mortality rate. Among 54 patients with mechanical injuries, patients with cartilage related injury(n=17) had a significantly higher rate of tracheobronchial chondritis (64.7% vs 27%, P= 0.008), a significantly lower rate of auricular chondritis (35.3% vs 67.6%, P=0.026) and a relatively higher mortality rate(29.4% vs 8.1%, P=0.041) compared with those with non-cartilage related injury(n=37).Conclusion Our findings suggest that both cartilage-related and non-cartilage related injury may be triggers of RPC and patients with cartilage related injury seem to be more severe than those without.

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