Biram Codou Fall*, El hadji Daouda Niang, Assane Sall, Amadou Fall Cisse, Ahmadou Gaye, Aly Salane, Aichetou Fall, Bamba Diaw and Souhaibou Ndongo

Department of Internal Medicine, CHN Dalal Jamm, Senegal

*Corresponding Author: Biram Codou Fall, Department of Internal Medicine, CHN Dalal Jamm, Senegal.

Received: December 10, 2021; Published: December 20, 2021

Abstract

Introduction: Atrophying polychondritis is a rare auto-immune disease characterized by recurrent episodes of inflammation of cartilage tissue. Ocular involvement may occur in 60-70% of cases. Moreen's pseudo-ulcer is a rare complication. It is serious because of the visual prognosis. We report a case of Mooren's pseudo-ulcer revealing atrophic polychondritis.

Observation: A 49 year old female patient, followed in ophthalmology for a pain in the left eye associated with chemosis, lacrimation, photophobia and a decrease of visual acuity in the right eye. The ophthalmological examination showed a superinfected pseudo Mooren's ulcer of the right eye on slit lamp examination. She consulted dermatology for an irritative dermatitis of the feet. She was referred to internal medicine for an opinion on an inflammatory auricular swelling. On examination, she presented a chronic polychondritis with (Chondritis of the right ear with atrophy, nasal chondritis without "saddle" or "marmite feet" deformity, chondro-costal chondritis) without hypoacusis, without vestibular syndrome; a chronic peripheral polyarthritis, and not deforming. Biology showed a moderate chronic inflammatory syndrome. Immunological investigations were negative. Cardiovascular and respiratory function tests are in progress. The diagnosis of chronic atrophic polychondritis was retained in the presence of 2 major and 1 minor criteria according to the Michet criteria and the presence of 4 out of 6 criteria according to the McAdam criteria. A treatment based on methylprednisone and Azathioprine was prescribed. The patients showed good progress under treatment with improvement of polyarthritis, polychondritis and ocular inflammation.

Conclusion: Atrophying polychondritis is a rare autoimmune disease with a recurrent and sometimes severe course. Ocular involvement is usual during the course of the disease and can be inaugural as shown in this observation. The présence of a Mooren's pseudo-ulcer should be investigated for this etiology.

Keywords: Chronic Atrophying Polychondritis; Pseudo Mooren; Africa

References

1. Mathew SD., et al. “Relapsing Polychondritis in the Department of Defense Population and Review of the Literature”. Seminars in Arthritis and Rheumatism 1 (2012): 70‑83.
2. Lahmer T., et al. “Relapsing polychondritis: An autoimmune disease with many faces”. Autoimmune Review8 (2010): 540‑546.
3. Gning SB., et al. “Polychondrite atrophiante associée à un adénocarcinome rectal et une fibromatose musculoaponévrotique chez une Africaine”. La Revue de Médecine Interne 9 (2001): 891‑893.
4. Pearson CM., et al. “Relapsing Polychondritis”. The New England Journal of Medicine 2 (1960): 51‑58.
5. Horvath A., et al. “A nationwide study of the epidemiology of relapsing polychondritis”. Clinical Epidemiology 8 (2016): 211‑2
6. Wood TO and Kaufman HE. “Mooren’s Ulcer”. American Journal of Ophthalmology1 (1971): 417‑422.
7. Ouedraogo N., et al. “Pseudo-ulcère de Mooren révélant une polychondrite atrophiante”. La Revue de Médecine Interne 39 (2018): A224.
8. Dion J., et al. “Polychondrite atrophiante : actualités en 2017”. La Revue de Médecine Interne 6 (2018): 400‑407.
9. Dion J., et al. “Relapsing Polychondritis Can Be Characterized by Three Different Clinical Phenotypes: Analysis of a Recent Series of 142 Patients: RP can be divided into three clinical phenotypes”. Arthritis Rheumatology12 (2016): 2992‑3001.
10. Chang S-J., et al. “Laryngotracheal Involvement as the Initial Manifestation of Relapsing Polychondritis”. Journal of the Chinese Medical Association 6 (2005): 279‑282.
11. McAdam LP., et al. “Relapsing polychondritis: prospective study of 23 patients and a review of the literature”. Medicine (Baltimore)3 (1976): 193‑215.
12. Jawad AS., et al. “Erosive arthritis in relapsing polychondritis”. Postgraduate Medical Journal779 (1990): 768‑770.
13. Francès C., et al. “Dermatologic Manifestations of Relapsing Polychondritis: A Study of 200 Cases at a Single Center”. Medicine (Baltimore)3 (2001): 173‑179.
14. Damiani JM and Levine HL. “Relapsing polychondritis--report of ten cases”. The Laryngoscope 89 (1979): 929‑9
15. Trentham DE. “Relapsing Polychondritis”. Annals of Internal Medicine2 (1998): 114.
16. Watson PG. “Management of Mooren’s ulceration”. Eye3 (1997): 349‑356.

Citation

Citation: Biram Codou Fall., et al. “Mooren's Pseudoulcer Revealing Chronic Atrophic Polychondritis". Acta Scientific Medical Sciences 6.1 (2022): 180-184.

Copyright

Copyright: © 2022 Biram Codou Fall., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.