智歯抜歯を行った再発性多発軟骨炎患者の1例
Relapsing polychondritis (RP) is a rare chronic inflammatory disease specific to cartilage tissue. Treatment of RP is aimed at preventing destruction of the cartilage tissue and involves the use of multiple immunosuppressive drugs. Postoperative infection should be considered in cases of RP because...
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| Published in | 日本口腔外科学会雑誌 Vol. 70; no. 6; pp. 261 - 266 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益社団法人 日本口腔外科学会
20.06.2024
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.70.261 |
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| Abstract | Relapsing polychondritis (RP) is a rare chronic inflammatory disease specific to cartilage tissue. Treatment of RP is aimed at preventing destruction of the cartilage tissue and involves the use of multiple immunosuppressive drugs. Postoperative infection should be considered in cases of RP because infection is a trigger for disease relapse. A 28-year-old man was referred to our department for extraction of the third molars in June 2022. The patient was diagnosed with RP in September 2009. He was taking multiple immunosuppressive drugs. The clinical diagnosis was carious third molars with pericoronitis. He was hospitalized for the extractions in July 2022. Prophylactic antimicrobials were administered without discontinuation of regular medication and tooth extraction was performed. The patient was monitored for signs of RP relapse during the follow-up. At 21 days postoperatively, no signs of infection or RP relapse were observed; further, epithelialization was confirmed and the patient was doing well. |
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| AbstractList | Relapsing polychondritis (RP) is a rare chronic inflammatory disease specific to cartilage tissue. Treatment of RP is aimed at preventing destruction of the cartilage tissue and involves the use of multiple immunosuppressive drugs. Postoperative infection should be considered in cases of RP because infection is a trigger for disease relapse. A 28-year-old man was referred to our department for extraction of the third molars in June 2022. The patient was diagnosed with RP in September 2009. He was taking multiple immunosuppressive drugs. The clinical diagnosis was carious third molars with pericoronitis. He was hospitalized for the extractions in July 2022. Prophylactic antimicrobials were administered without discontinuation of regular medication and tooth extraction was performed. The patient was monitored for signs of RP relapse during the follow-up. At 21 days postoperatively, no signs of infection or RP relapse were observed; further, epithelialization was confirmed and the patient was doing well. |
| Author | 外山, 直人 鈴木, 秀祐 井出, 貴洋 藤本, 雄大 南部, 和也 石川, 純 |
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| References | 14) 金 英寛，齊藤貴志，他：再発性多発軟骨炎に対して人工股関節全置換術を実施した１例．日人工関節会誌 44: 735-736, 2014. 1) 鈴木 登：再発性多発軟骨炎．リウマチ科 54: 60-66, 2015. 11) Damiani JM and Levine HL : Relapsing polychondritis-report of ten cases. Laryngoscope 89: 929-46, 1979. 8) Chopra R, ChaudharyN, et al : Relapsing polychondritis. Rheum Dis Clin North Am 39: 263-276, 2013. 10) Alsalameh S, Mollenhauer J, et al : Preferential cellular and humoral immune reactivities to native and denatured collagen types Ⅸ and Ⅺ in a patient with fatal relapsing polychondritis. J Rheumatol 20: 1419-1424, 1993. 4) 向井明彦，中筋徹也：長期観察し得た再発生多発軟骨炎 (Relapsing Polychondritis) の３症例 −再発における誘因と治療方針について−．リウマチ 5: 717-724, 1998. 6) Pearson CM, Kline HM, et al : Relapsing polychondritis. N Engl J Med 263: 51-58, 1960. 18) Rednic S, Damian L, et al : Relapsing polychondritis: state of the art on clinical practice guidelines. RMD Open 18: 4, 2018. 20) Caroline J and Warrick JI : Management of adrenal insufficiency during the stress of medical illness and surgery. Méd J Aust 12: 409-413, 2008. 7) Oka H, Yamano Y, et al : A large-scale survey of patients with relapsing polychondritis in Japan. Inflamm Regen 34: 149-156, 2014. 13) Selvi F, Messina J, et al : Relapsing polychondritis concomitant with synovial chondromatosis of the Temporomandibular Joint. J Oral Maxillofac Surg 74: 2207-2215, 2016. 21) 中野真祐，鬼澤浩司郎，他：ステロイド薬服用患者における抜歯時の管理．口科誌 51: 335-339, 2002. 22) 沖永耕平，吉川博雅，他：副腎皮質ステロイド薬服用患者の局所麻酔下での抜歯時での管理に関する検討．日有病歯誌 27: 2-7, 2018. 3) Harada M, Yoshida H, et al : Relapsing polychondritis associated with subclinical Sjögren’s syndrome and phlegmon of the neck. Internal Med 34: 768-771, 1995. 16) 大友 純，田代雅文，他：再発性多発軟骨炎患者の麻酔経験．麻酔 56: 831-834, 2007. 2) Son SB, Han WH, et al : Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft. Clin Exp Otorhinolaryngol 7: 63-65, 2014. 19) Arnaud L, Devilliers H, et al : The relapsing polychondritis disease activity index: development of a disease activity score for relapsing polychondritis. Autoimmun Rev 12: 204-209, 2012. 5) McAdam LP, O’Hanlan MA, et al : Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine （Baltimore) 55: 193-215, 1976. 15) 信太賢治，細山田明義，他：再発性多発軟骨炎の麻酔経験．麻酔 51: 289-292, 2002. 17) Iida M, Orime Y, et al : Emergency repair of acute aortic dissection in a patient with relapsing polychondritis. Ann Thorac Cardiovasc Surg 19: 158-161, 2013. 12) 南 留美，宮村知也，他：当科で経験した再発性多発軟骨炎５例の臨床的検討．日臨免疫会誌 32: 269-273, 2009. 9) Arnaud L, Mathian A, et al : Pathogenesis of relapsing polychondritis: A 2013 update. Autoimmun Rev 13: 90-95, 2014. |
| References_xml | – reference: 18) Rednic S, Damian L, et al : Relapsing polychondritis: state of the art on clinical practice guidelines. RMD Open 18: 4, 2018. – reference: 5) McAdam LP, O’Hanlan MA, et al : Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine （Baltimore) 55: 193-215, 1976. – reference: 15) 信太賢治，細山田明義，他：再発性多発軟骨炎の麻酔経験．麻酔 51: 289-292, 2002. – reference: 17) Iida M, Orime Y, et al : Emergency repair of acute aortic dissection in a patient with relapsing polychondritis. Ann Thorac Cardiovasc Surg 19: 158-161, 2013. – reference: 13) Selvi F, Messina J, et al : Relapsing polychondritis concomitant with synovial chondromatosis of the Temporomandibular Joint. J Oral Maxillofac Surg 74: 2207-2215, 2016. – reference: 16) 大友 純，田代雅文，他：再発性多発軟骨炎患者の麻酔経験．麻酔 56: 831-834, 2007. – reference: 22) 沖永耕平，吉川博雅，他：副腎皮質ステロイド薬服用患者の局所麻酔下での抜歯時での管理に関する検討．日有病歯誌 27: 2-7, 2018. – reference: 9) Arnaud L, Mathian A, et al : Pathogenesis of relapsing polychondritis: A 2013 update. Autoimmun Rev 13: 90-95, 2014. – reference: 12) 南 留美，宮村知也，他：当科で経験した再発性多発軟骨炎５例の臨床的検討．日臨免疫会誌 32: 269-273, 2009. – reference: 8) Chopra R, ChaudharyN, et al : Relapsing polychondritis. Rheum Dis Clin North Am 39: 263-276, 2013. – reference: 21) 中野真祐，鬼澤浩司郎，他：ステロイド薬服用患者における抜歯時の管理．口科誌 51: 335-339, 2002. – reference: 4) 向井明彦，中筋徹也：長期観察し得た再発生多発軟骨炎 (Relapsing Polychondritis) の３症例 −再発における誘因と治療方針について−．リウマチ 5: 717-724, 1998. – reference: 14) 金 英寛，齊藤貴志，他：再発性多発軟骨炎に対して人工股関節全置換術を実施した１例．日人工関節会誌 44: 735-736, 2014. – reference: 20) Caroline J and Warrick JI : Management of adrenal insufficiency during the stress of medical illness and surgery. Méd J Aust 12: 409-413, 2008. – reference: 6) Pearson CM, Kline HM, et al : Relapsing polychondritis. N Engl J Med 263: 51-58, 1960. – reference: 3) Harada M, Yoshida H, et al : Relapsing polychondritis associated with subclinical Sjögren’s syndrome and phlegmon of the neck. Internal Med 34: 768-771, 1995. – reference: 2) Son SB, Han WH, et al : Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft. Clin Exp Otorhinolaryngol 7: 63-65, 2014. – reference: 10) Alsalameh S, Mollenhauer J, et al : Preferential cellular and humoral immune reactivities to native and denatured collagen types Ⅸ and Ⅺ in a patient with fatal relapsing polychondritis. J Rheumatol 20: 1419-1424, 1993. – reference: 7) Oka H, Yamano Y, et al : A large-scale survey of patients with relapsing polychondritis in Japan. Inflamm Regen 34: 149-156, 2014. – reference: 11) Damiani JM and Levine HL : Relapsing polychondritis-report of ten cases. Laryngoscope 89: 929-46, 1979. – reference: 19) Arnaud L, Devilliers H, et al : The relapsing polychondritis disease activity index: development of a disease activity score for relapsing polychondritis. Autoimmun Rev 12: 204-209, 2012. – reference: 1) 鈴木 登：再発性多発軟骨炎．リウマチ科 54: 60-66, 2015. |
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| SubjectTerms | 再発性多発軟骨炎 周術期管理 智歯抜歯 |
| Title | 智歯抜歯を行った再発性多発軟骨炎患者の1例 |
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