mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2023-6-109-114mrj-1502Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSРецидивирующий полихондрит, развившийся после пирсинга (клинический случай)Relapsing polychondritis that developed after piercing (clinical case)https://orcid.org/0009-0002-3473-2480МовсесянА. А.MovsesyanA. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

an.ar.mov@mail.ruhttps://orcid.org/0000-0002-4505-0162КрасненкоС. О.KrasnenkoS. O.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-9755-5760УрумоваМ. М.UrumovaM. M.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

https://orcid.org/0000-0002-5493-6045ГодзенкоА. А.GodzenkoA. A.

115522, Москва, Каширское шоссе, 34А;

кафедра ревматологии, 125993, Москва, ул. Баррикадная, 2/1, стр. 1

34A, Kashirskoe Shosse, Moscow 115522;

Department of Rheumatology, 2/1, Barrikadnaya Street, Build. 1, Moscow 125993

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaRussian Federation202318122023176109114Copyright © Мовсесян А.А., Красненко С.О., Урумова М.М., Годзенко А.А., 20232023Мовсесян А.А., Красненко С.О., Урумова М.М., Годзенко А.А.Movsesyan A.A., Krasnenko S.O., Urumova M.M., Godzenko A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1502

Рецидивирующий полихондрит (РПХ) относится к группе редких ревматических заболеваний с недостаточно изученными этиологией и патогенезом. В его основе лежит прогрессирующее системное воспалительное поражение хрящевой ткани с преимущественным вовлечением ушных раковин, носа, трахеи и бронхов. Унифицированного подхода к лечению РПХ не разработано, поэтому тактика ведения каждого пациента индивидуальна.

Описан случай развития РПХ у 39-летней пациентки после пирсинга хрящевой части ушной раковины. Компоненты сплава, использовавшегося для пирсинга, предположительно могли послужить адъювантами и спровоцировать развитие заболевания, сходного с синдромом ASIA (аутоиммунный/воспалительный синдром, индуцированный адъювантами) с воспалением хрящей носа и ушных раковин. Представлены возможные патогенетические механизмы, а также диагностические критерии синдрома ASIA.

Relapsing polychondritis (RPC) belongs to a group of rare rheumatic diseases with poorly understood etiology and pathogenesis. It is based on progressive systemic inflammatory damage to the cartilage tissue, primarily affecting ears, nose, trachea and bronchi. A standardized approach for the treatment of RPC has not yet been developed, so the treatment tactics are individualized for each patient.

We describe a clinical case of a 39-year-old patient, who developed RPC after piercing the cartilaginous part of the ear. The components of the alloy used for the piercing could presumably serve as adjuvants and cause the development of a disease similar to ASIA syndrome (Autoimmune/Inflammatory Syndrome Induced by Adjuvants) with inflammation of the cartilage of the nose and ears. Possible pathogenetic mechanisms are presented, as well as diagnostic criteria for ASIA syndrome.

рецидивирующий полихондритадъювантыASIA-синдромrelapsing polychondritisadjuvantsASIA syndromeReferencesBorgia F, Giuffrida R, Guarneri F, Cannavo SP. Relapsing Polychondritis: An Updated Review. Biomedicines. 2018 Aug 2; 6(3):84. doi: 10.3390/biomedicines6030084.Borgia F, Giuffrida R, Guarneri F, Cannavo SP. Relapsing Polychondritis: An Updated Review. Biomedicines. 2018 Aug 2; 6(3):84. doi: 10.3390/biomedicines6030084.Jaksch-Wartenhorst R. Polychondropathia. WienArch F Inn Med. 1923;(6):93-100.Jaksch-Wartenhorst R. Polychondropathia. WienArch F Inn Med. 1923;(6):93-100.Balsa A, Expinosa A, Cuesta M, et al. Joint symptoms in relapsingpolychondritis. Clin Exp Rheumatol. 1995 Jul-Aug;13(4):425-30.Balsa A, Expinosa A, Cuesta M, et al. Joint symptoms in relapsingpolychondritis. Clin Exp Rheumatol. 1995 Jul-Aug;13(4):425-30.Zeuner M, Straub RH, Rauh G, et al. Relapsing polychondritis: clinical and immunogenetic analysis of 62 patients. J Rheumatol. 1997 Jan;24(1):96-101.Zeuner M, Straub RH, Rauh G, et al. Relapsing polychondritis: clinical and immunogenetic analysis of 62 patients. J Rheumatol. 1997 Jan;24(1):96-101.Yang CL, Brinckmann J, Rui HF, et al. Autoantibodies to cartilage collagens in relapsing polychondritis. Arch Dermatol Res. 1993; 285(5):245-9. doi: 10.1007/BF00371591.Yang CL, Brinckmann J, Rui HF, et al. Autoantibodies to cartilage collagens in relapsing polychondritis. Arch Dermatol Res. 1993; 285(5):245-9. doi: 10.1007/BF00371591.Kempta Lekpa F, Piette JC, BastujiGarin S, et al. Serum cartilage oligomeric matrix protein (COMP) level is a marker of disease activity in relapsing polychondritis. Clin Exp Rheumatol. 2010 Jul-Aug;28(4):553-5. Epub 2010 Aug 30.Kempta Lekpa F, Piette JC, BastujiGarin S, et al. Serum cartilage oligomeric matrix protein (COMP) level is a marker of disease activity in relapsing polychondritis. Clin Exp Rheumatol. 2010 Jul-Aug;28(4):553-5. Epub 2010 Aug 30.Ouchi N, Uzuki M, Kamataki A, et al. Cartilage destruction is partly induced by the internal proteolytic enzymes and apoptotic phenomenon of chondrocytes in relapsing polychondritis. J Rheumatol. 2011 Apr;38(4):730-7. doi: 10.3899/jrheum.101044. Epub 2011 Jan 15.Ouchi N, Uzuki M, Kamataki A, et al. Cartilage destruction is partly induced by the internal proteolytic enzymes and apoptotic phenomenon of chondrocytes in relapsing polychondritis. J Rheumatol. 2011 Apr;38(4):730-7. doi: 10.3899/jrheum.101044. Epub 2011 Jan 15.Arnaud L, Mathian A, Haroche J, et al. Pathogenesis of relapsing polychondritis: A 2013 update. Autoimmun Rev. 2014 Feb; 13(2):90-5. doi: 10.1016/j.autrev.2013.07.005. Epub 2013 Sep 17.Arnaud L, Mathian A, Haroche J, et al. Pathogenesis of relapsing polychondritis: A 2013 update. Autoimmun Rev. 2014 Feb; 13(2):90-5. doi: 10.1016/j.autrev.2013.07.005. Epub 2013 Sep 17.Son SB, Han WH, Park JH, et al. Aggravation of relapsing polychondritis due to the infection and its manifestation on a nasal tip graft. Clin Exp Otorhinolaryngol. 2014 Mar;7(1): 63-5. doi: 10.3342/ceo.2014.7.1.63. Epub 2014 Feb 5.Son SB, Han WH, Park JH, et al. Aggravation of relapsing polychondritis due to the infection and its manifestation on a nasal tip graft. Clin Exp Otorhinolaryngol. 2014 Mar;7(1): 63-5. doi: 10.3342/ceo.2014.7.1.63. Epub 2014 Feb 5.Michet CJ, McKenna CH, Luthra HS, O’Fallon WM. Relapsing polychondritis: Survival and predictive role of early disease manifestations. Ann Intern Med. 1986 Jan;104(1): 74-8. doi: 10.7326/0003-4819-104-1-74.Michet CJ, McKenna CH, Luthra HS, O’Fallon WM. Relapsing polychondritis: Survival and predictive role of early disease manifestations. Ann Intern Med. 1986 Jan;104(1): 74-8. doi: 10.7326/0003-4819-104-1-74.Kashihara K, Kawada S, Takahashi Y. Autoantibodies to glutamate receptor GluRepsilon2 in a patient with limbic encephalitis associated with relapsing polychondritis. J Neurol Sci. 2009 Dec 15;287(1-2):275-7. doi: 10.1016/j.jns.2009.08.004. Epub 2009 Aug 28.Kashihara K, Kawada S, Takahashi Y. Autoantibodies to glutamate receptor GluRepsilon2 in a patient with limbic encephalitis associated with relapsing polychondritis. J Neurol Sci. 2009 Dec 15;287(1-2):275-7. doi: 10.1016/j.jns.2009.08.004. Epub 2009 Aug 28.Kent PD, Mitchet CJ Jr, Luthra HS. Relapsing polychondritis. Curr Opin Rheumatol. 2004 Jan;16(1):56-61. doi: 10.1097/00002281-200401000-00011.Kent PD, Mitchet CJ Jr, Luthra HS. Relapsing polychondritis. Curr Opin Rheumatol. 2004 Jan;16(1):56-61. doi: 10.1097/00002281-200401000-00011.Chang SJ, Lu CC, Chung YM, et al. Laryngotracheal involvement as the initial manifestation of relapsing polychondritis. J Chin Med Assoc. 2005 Jun;68(6):279-82. doi: 10.1016/S1726-4901(09)70151-0.Chang SJ, Lu CC, Chung YM, et al. Laryngotracheal involvement as the initial manifestation of relapsing polychondritis. J Chin Med Assoc. 2005 Jun;68(6):279-82. doi: 10.1016/S1726-4901(09)70151-0.Ernst A, Rafeq S, Boiselle P, et al. Relapsing polychondritis and airway involvement. Chest. 2009 Apr;135(4):1024-1030. doi: 10.1378/chest.08-1180. Epub 2008 Nov 18.Ernst A, Rafeq S, Boiselle P, et al. Relapsing polychondritis and airway involvement. Chest. 2009 Apr;135(4):1024-1030. doi: 10.1378/chest.08-1180. Epub 2008 Nov 18.Baretto SN, Oliveira GN, Michet CJ, et al. Multiple cardiovascular complications in a patient with relapsing polychondritis. Mayo Clin Proc. 2002 Sep;77(9):971-4. doi: 10.4065/77.9.971.Baretto SN, Oliveira GN, Michet CJ, et al. Multiple cardiovascular complications in a patient with relapsing polychondritis. Mayo Clin Proc. 2002 Sep;77(9):971-4. doi: 10.4065/77.9.971.Савельев АИ, Черняк ВИ, Вороненкова ЕА, Шаркова ЮВ. Десять случаев рецидивирующего полихондрита. В кн.: Ольбинская ЛИ, редактор. Актуальные вопросы внутренней медицины: Сборник научных трудов. Москва; 2000. С. 244-56.Savel'ev AI, Chernyak VI, Voronenkova EA, Sharkova YuV. Ten cases of recurrent polychondritis. In: Ol'binskaya LI, editor. Aktual'nye voprosy vnutrennei meditsiny: Sbornik nauchnykh trudov [Topical issues of internal medicine: Collection of scientific papers]. Moscow; 2000: P. 244-56.Hsu KC, Wu YR, Lyu RK, et al. Aseptic meningitis and ischemic stroke in relapsing polychondritis. Clin Rheumatol. 2006 Mar; 25(2):265-7. doi: 10.1007/s10067-005-1152-3. Epub 2005 Jul 26.Hsu KC, Wu YR, Lyu RK, et al. Aseptic meningitis and ischemic stroke in relapsing polychondritis. Clin Rheumatol. 2006 Mar; 25(2):265-7. doi: 10.1007/s10067-005-1152-3. Epub 2005 Jul 26.McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: Prospective study of 23 patientsand a review of the literature. Medicine (Baltimore). 1976 May; 55(3):193-215.McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM. Relapsing polychondritis: Prospective study of 23 patientsand a review of the literature. Medicine (Baltimore). 1976 May; 55(3):193-215.Asadi AK. Relapsing polychondritis. Dermatol Online J. 2003 Oct;9(4):3.Asadi AK. Relapsing polychondritis. Dermatol Online J. 2003 Oct;9(4):3.Тюрин ВП, Мезенова ТВ. Успешная диагностика и лечение рецидивирующего полихондрита. Вестник Национального медико-хирургического центра им. Н.И. Пирогова. 2006;3(2):37-43.TyurinVP, Mezenova TV. Successful diagnosis and treatment of recurrent polychondritis. Vestnik Natsional'nogo Mediko-Khirurgicheskogo Tsentra im. N.I. Pirogova. 2006;3(2): 37-43. (In Russ.).Черняк ВИ, Савельев АИ, Погромов АП. Рецидивирующий полихондрит. Клиническая медицина. 2014;92(11):22-8.ChernyakVI, Savel'evAI, PogromovAP. Recurrent polychondritis. Klinicheskaya Meditsina. 2014;92(11):22-8. (In Russ.).Сайковский РС, Бабак ВВ, Григорьева МА. Рецидивирующий полихондрит. Случай из практики.Клиническая практика. 2011;(4):44-9.Saykovskiy RS, Babak VV, Grigor'eva MA. Recurrent polychondritis. Case study. Klinicheskaya Praktika. 2011;(4):44-9. (In Russ.).Black CM, Pereira S, McWrirter A, et al. Genetic susceptibility to scleroderma-like syndrome in symptomatic and asymptomatic workers exposed to vinyl chloride. J Rheumatol. 1986 Dec;13(6):1059-62.Black CM, Pereira S, McWrirter A, et al. Genetic susceptibility to scleroderma-like syndrome in symptomatic and asymptomatic workers exposed to vinyl chloride. J Rheumatol. 1986 Dec;13(6):1059-62.Кряжева СС, Хамаганова ИВ, Макушина ЗВ. Бляшечная склеродермия, развившаяся после инъекций пенициллина. Вестник дерматологии.1992;(1):43-45.Kryazheva SS, Hamaganova IV, Makushina ZV. Plaque scleroderma developed after penicillin injections. Vestnik dermatologii. 1992;(1):43–45. (In Russ.).Куницкая НА. Индуцированная склеродермия – необычный случай развития. Sciences of Europe. 2020;(55):15-18.Kunickaya NA. Induced scleroderma – an unusual case of development. Sciences of Europe. 2020;(55):15-18. (InRuss.).Shoenfeld Y, Agmon-Levin N. 'ASIA' – autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011 Feb; 36(1):4-8. doi: 10.1016/j.jaut.2010.07.003.Shoenfeld Y, Agmon-Levin N. 'ASIA' – autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011 Feb; 36(1):4-8. doi: 10.1016/j.jaut.2010.07.003.Золотых ВГ. «После» не значит – «вследствие»? ASIA-синдром в течение годового наблюдения пациенток с операциями на молочных железах. От Иегуды Шенфельда – к Роману Баевскому. Russian Biomedical Research. 2021;6(2):3-14.Zolotykh VG. "After" does not mean – "due to"? ASIA-syndrome during the annual follow-up of patients with breast surgery. From Yehuda Shenfeld to Roman Baevsky. Russian Biomedical Research. 2021;6(2):3-14. (In Russ.).Burek CL, Talor MV. Environmental triggers of autoimmune thyroiditis. J Autoimmun. 2009 Nov-Dec;33(3-4):183-9.Burek CL, Talor MV. Environmental triggers of autoimmune thyroiditis. J Autoimmun. 2009 Nov-Dec;33(3-4):183-9.Vermeulen RC, Scholte HR. Rupture of siliconegel breastimplants and symptoms of pain and fatigue. J Rheumatol. 2003 Oct; 30(10):2263-7.Vermeulen RC, Scholte HR. Rupture of siliconegel breastimplants and symptoms of pain and fatigue. J Rheumatol. 2003 Oct; 30(10):2263-7.Brown SL, Pennello G, Berg WA, et al. Siliconegel breastimplant rupture, extracapsular silicone, and health status in a population of women. J Rheumatol. 2001 May;28(5): 996-1003.Brown SL, Pennello G, Berg WA, et al. Siliconegel breastimplant rupture, extracapsular silicone, and health status in a population of women. J Rheumatol. 2001 May;28(5): 996-1003.Marrack P, McKee AS, Munks MW. Towards an understanding of the adjuvant action of aluminium. Nat Rev Immunol. 2009 Apr;9(4):287-93. doi: 10.1038/nri2510.Marrack P, McKee AS, Munks MW. Towards an understanding of the adjuvant action of aluminium. Nat Rev Immunol. 2009 Apr;9(4):287-93. doi: 10.1038/nri2510.Fryzek JP, Signorello LB, Hakelius L, et al. Self-reported symptoms among women after cosmetic breastimplantand breastreduction surgery. Plast Reconstr Surg. 2001 Jan; 107(1):206-13. doi: 10.1097/00006534-200101000-00034.Fryzek JP, Signorello LB, Hakelius L, et al. Self-reported symptoms among women after cosmetic breastimplantand breastreduction surgery. Plast Reconstr Surg. 2001 Jan; 107(1):206-13. doi: 10.1097/00006534-200101000-00034.Vasey FB, Zarabadi SA, Seleznick M, Ricca L. Where there's smoke there's fire: the silicone breastimplant controversy continue stoflicker: a new disease that needs to be defined. J Rheumatol. 2003 Oct;30(10):2092-4.Vasey FB, Zarabadi SA, Seleznick M, Ricca L. Where there's smoke there's fire: the silicone breastimplant controversy continue stoflicker: a new disease that needs to be defined. J Rheumatol. 2003 Oct;30(10):2092-4.Janowsky EC, Kupper LL, Hulka BS. Meta-analyses of the relation between silicone breastimplants and the risk of connective-tissue diseases. N Engl J Med. 2000 Mar 16; 342(11):781-90. doi: 10.1056/NEJM200003163421105Janowsky EC, Kupper LL, Hulka BS. Meta-analyses of the relation between silicone breastimplants and the risk of connective-tissue diseases. N Engl J Med. 2000 Mar 16; 342(11):781-90. doi: 10.1056/NEJM200003163421105Chauhan U, Cassidy B, Cohen Tervaert JW. ASIA (Shoenfeld’s syndrome) due to hysteroscopic Essure sterilization. Autoimmun Rev. 2021 Dec;20(12):102979. doi: 10.1016/j.autrev.2021.102979. Epub 2021 Nov 6.Chauhan U, Cassidy B, Cohen Tervaert JW. ASIA (Shoenfeld’s syndrome) due to hysteroscopic Essure sterilization. Autoimmun Rev. 2021 Dec;20(12):102979. doi: 10.1016/j.autrev.2021.102979. Epub 2021 Nov 6.Tervaert JWC, Martinez-Lavin M, Jara LJ, et al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023. Autoimmun Rev. 2023 May;22(5):103287. doi: 10.1016/j.autrev.2023.103287. Epub 2023 Feb 3.Tervaert JWC, Martinez-Lavin M, Jara LJ, et al. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) in 2023. Autoimmun Rev. 2023 May;22(5):103287. doi: 10.1016/j.autrev.2023.103287. Epub 2023 Feb 3.Parums DV. Editorial: SARS-CoV-2 mRNA Vaccines and the Possible Mechanism of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). Med Sci Monit. 2021 Apr 26:27:e932899. doi: 10.12659/MSM.932899.Parums DV. Editorial: SARS-CoV-2 mRNA Vaccines and the Possible Mechanism of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). Med Sci Monit. 2021 Apr 26:27:e932899. doi: 10.12659/MSM.932899.Chen Y, Xu Z, Wang P, et al. New-onset autoimmune phenomena post-COVID-19 vaccination. Immunology. 2022 Apr;165(4): 386-401. doi: 10.1111/imm.13443. Epub 2022 Jan 7.Chen Y, Xu Z, Wang P, et al. New-onset autoimmune phenomena post-COVID-19 vaccination. Immunology. 2022 Apr;165(4): 386-401. doi: 10.1111/imm.13443. Epub 2022 Jan 7.

The authors declare that there are no conflicts of interest present.