Advertisement

Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Anesthetic management of the parturient with relapsing polychondritis

[Anesthésie ďune parturiente atteinte de polychondrite chronique atrophiante]

  • 317 Accesses

  • 3 Citations

Abstract

Purpose

To present the anesthetic management of a parturient with relapsing polychondritis (RP) and to discuss the anesthetic implications of R P.

Clinical features

A 28-yr-old primiparous woman with known R P, spondyloarthropathy and fibromyalgia presented for urgent Cesarean delivery for breech presentation and prodromal labour. Her pregnancy had been complicated by a hospital admission for an exacerbation of her RP as manifested by hoarseness, increased pain and tenderness of her left ear and nasal bridge cartilages, sinusitis with bloody nasal discharge and increased pain and tenderness of the anterior tracheal rings. Epidural anesthesia was administered for the Cesarean delivery. Her intraoperative and postoperative course was uneventful. Close cooperation among obstetricians, anesthesiologists and rheumatologists resulted in a successful outcome.

Conclusion

Relapsing polychondritis is a syndrome with important anesthetic implications. Multidisciplinary cooperation is essential in managing these high risk parturients.

Résumé

Objectif

Présenter ľanesthésie ďune parturiente atteinte de polychondrite chronique (PC) et discuter des implications anesthésiques de la PC.

Éléments cliniques

Une primipare de 28 ans, suivie pour PC, spondylarthropathie et fibromyalgie, a été admise pour une césarienne ďurgence à cause ďune présentation du siège et ďun faux travail. La grossesse s’était compliquée ďune hospitalisation pour exacerbation de la PC manifestée par la raucité de la voix, une douleur et une sensibilité plus grande de ľoreille gauche et des cartilages de la racine du nez, une sinusite avec écoulement nasal sanguinolent et une douleur et une sensibilité accrues des cartilages antérieurs de la trachée. La césarienne, réalisée sous anesthésie péridurale, a connu une évolution peropératoire et postopératoire sans incident grâce à la collaboration étroite des obstétriciens, anesthésiologistes et rhumatologues.

Conclusion

Les parturientes atteintes de PC sont à haut risque et doivent être prises en charge par une équipe multidisciplinaire.

References

  1. 1

    Trentham DE, Le CH. Relapsing polychondritis (clinical review). Ann Int Med 1998; 129: 114–22.

  2. 2

    Harisdangkul V. Relapsing polychondritis.In: Klippel JH (Ed.). Primer on the Rheumatic Diseases, 12th ed. Atlanta, GA: Arthritis Foundation; 2001: 419–22.

  3. 3

    Appendix 1. Criteria for the classification and diagnosis of the rheumatic diseases.In: Klippel JH (Ed.). Primer on the Rheumatic Diseases, 12th ed. Atlanta, GA: Arthritis Foundation; 2001: 631, 635.

  4. 4

    Eng J, Sabanathan S. Airway complications in relapsing polychondritis. Ann Thorac Surg 1991; 51: 686–92.

  5. 5

    Selim AGA, Fulford LG, Mohiaddin RH, Sheppard MN. Active aortitis in relapsing polychondritis. J Clin Pathol 2001; 54: 890–2.

  6. 6

    Bellamy N, Dewar CL. Relapsing polychondritis in pregnancy. J Rheumatol 1990; 17: 1525–6.

  7. 7

    Gimovsky ML, Nishiyama M. Relapsing polychondritis in pregnancy: a case report and review. Am J Obstet Gynecol 1989; 161: 332–4.

  8. 8

    Papo T, Wechsler B, Bletry O, Piette AM, Godeau P, Piette JC. Pregnancy in relapsing polychondritis. Twenty-five pregnancies in eleven patients. Arthritis Rheum 1997; 40: 1245–9.

  9. 9

    Tsanadis GD, Chouliara ST, Voulgari PV, Makrydimas GV, Drosos AA. Outcome of pregnancy in a patient with relapsing polychondritis and pyoderma gangrenosum (Letter). Clin Rheumatol 2002; 21: 538.

  10. 10

    Burgess FW, Whitlock W, David MJ, Patane PS. Anesthetic implications of relapsing polychondritis: a case report. Anesthesiology 1990; 73: 570–2.

  11. 11

    Hayward AW, Al-Shaikh B. Relapsing polychondritis and the anaesthetist. Anaesthesia 1988; 43: 573–7.

  12. 12

    Biro P, Rohling R, Schmid S, Matter C, Lang M. Anesthesia in a patient with acute respiratory insufficiency due to relapsing polychondritis. J Clin Anesth 1994; 6: 59–62.

  13. 13

    Fitzmaurice BG, Brodsky JB, Kee ST, Foppiano LE, McNutt J. Anesthetic management of a patient with relapsing polychondritis. J Cardiothorac Vasc Anesth 1999; 13: 309–11.

  14. 14

    Tso AS, Chung HS, Wu CY, et al. Anesthetic management of a patient with relapsing polychondritis - a case report. Acta Anaesthesiol Sin 2001; 39: 189–94.

Download references

Author information

Correspondence to M. Joanne Douglas or Stephanie Ensworth.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Douglas, M.J., Ensworth, S. Anesthetic management of the parturient with relapsing polychondritis. Can J Anesth 52, 967–970 (2005). https://doi.org/10.1007/BF03022060

Download citation