Abstract
Purpose: To increase documentation of Native American symptomatology and treatment response in rheumatologic disease.
Design: We present a case series of 3 Native American patients with relapsing polychondritis for documentation of symptom recognition and treatment response within this underrepresented population. Data was routinely collected retrospectively from the rheumatologic service at Northeastern Health Systems.
Results: Remission was successfully induced/achieved in all 3 patients with high dose corticosteroids (prednisone 1 mg/kg body weight, not to exceed 60 mg/d in a consolidated morning-dose followed by a gentle tapering schedule over several weeks). With an intention to serve as a disease-modifying anti-rheumatic drug (DMARD) therapy as well as a steroid-sparing agent, (anticipating long-term steroid-use), we initiated dapsone therapy in patient 1, and azathioprine therapy in patients 2 and 3; synchronously with corticosteroid therapy. Azathioprine was chosen in patient 3 due to associated inflammatory eye disease. Patient 1 is still requiring a low dose (2.5 mg daily) of prednisone in conjunction with dapsone, but is nearing a successful complete tapering off prednisone having been in remission for 2 years now. Patient 2 did not tolerate azathioprine well (significant nausea with persistent transaminitis and leukopenia), which led to its discontinuation. He has been successfully weaned off the prednisone since, and the RPC remains in remission for 18 months with the use of adalimumab monotherapy 40 mg subcutaneously every 2 weeks.
Discussion: RPC is a systemic inflammatory immune-mediated rheumatic disease (SIIRD) primarily affecting the cartilaginous structures within organs such as the ear, nose, joints, tracheobronchial tree, and cardiovascular system but it can also impact organs that are not primarily cartilage-based, such as skin, blood vessels, eyes and inner ear. Here we present 3 cases of RPC as an SIIRD from the American Indian/Alaska Native (AI/AN) population of the Cherokee Nation (CN), Oklahoma. To the best of our knowledge, this is the first publication of a series of RPC in the AI/AN population.
Design: We present a case series of 3 Native American patients with relapsing polychondritis for documentation of symptom recognition and treatment response within this underrepresented population. Data was routinely collected retrospectively from the rheumatologic service at Northeastern Health Systems.
Results: Remission was successfully induced/achieved in all 3 patients with high dose corticosteroids (prednisone 1 mg/kg body weight, not to exceed 60 mg/d in a consolidated morning-dose followed by a gentle tapering schedule over several weeks). With an intention to serve as a disease-modifying anti-rheumatic drug (DMARD) therapy as well as a steroid-sparing agent, (anticipating long-term steroid-use), we initiated dapsone therapy in patient 1, and azathioprine therapy in patients 2 and 3; synchronously with corticosteroid therapy. Azathioprine was chosen in patient 3 due to associated inflammatory eye disease. Patient 1 is still requiring a low dose (2.5 mg daily) of prednisone in conjunction with dapsone, but is nearing a successful complete tapering off prednisone having been in remission for 2 years now. Patient 2 did not tolerate azathioprine well (significant nausea with persistent transaminitis and leukopenia), which led to its discontinuation. He has been successfully weaned off the prednisone since, and the RPC remains in remission for 18 months with the use of adalimumab monotherapy 40 mg subcutaneously every 2 weeks.
Discussion: RPC is a systemic inflammatory immune-mediated rheumatic disease (SIIRD) primarily affecting the cartilaginous structures within organs such as the ear, nose, joints, tracheobronchial tree, and cardiovascular system but it can also impact organs that are not primarily cartilage-based, such as skin, blood vessels, eyes and inner ear. Here we present 3 cases of RPC as an SIIRD from the American Indian/Alaska Native (AI/AN) population of the Cherokee Nation (CN), Oklahoma. To the best of our knowledge, this is the first publication of a series of RPC in the AI/AN population.
Original language | American English |
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Pages | 36 |
State | Published - 13 Sep 2024 |
Event | 2024 Symposium on Tribal and Rural Innovations in Disparities and Equity for Health - Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, United States Duration: 13 Sep 2024 → 13 Sep 2024 |
Conference
Conference | 2024 Symposium on Tribal and Rural Innovations in Disparities and Equity for Health |
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Abbreviated title | STRIDE 2024 |
Country/Territory | United States |
City | Tahlequah |
Period | 13/09/24 → 13/09/24 |