Essence of relapse
Recidivus refers to the reappearance of a disease after it has been arrested or significantly mitigated. It is important to understand that the clinical presentation of a relapse most often duplicates the initial one. However, there are exceptions: for example, in chronic myeloid leukemia, a recurrent flare-up may manifest primarily with signs of anemia rather than the typical symptoms seen at onset.
Classification of remissions
The remissio period is a temporary "quiet phase" of the pathological process. Depending on the depth of this process, the following are distinguished:
- Complete remission: temporary but complete elimination of all clinical signs of the disease.
- Incomplete remission: a condition in which symptoms persist, but their severity is significantly reduced.
For a number of diseases, such as malaria or relapsing fever, the alternation of remissions and relapses is a natural stage of progression.
Complications and other outcomes
In addition to cyclic changes, a disease may be accompanied by the development of secondary pathological processes. They are not mandatory for the underlying disease, but arise as a result of its causative factors or pathogenetic links. A striking example is the development of angiopathies or comatose states in diabetes mellitus. In unfavorable cases, the disease may become chronic or lead to a fatal outcome.
Briefly: answers to topical questions
What risk factors and conditions contribute to breaking remission and developing a relapse?
Factors and conditions explicitly stated in sources as provoking a relapse or associated with its causes:
- hypothermia/chilling;
- intoxications;
- infections;
- drug intolerance, including to antibiotics and vitamins;
- in case of deep vein thrombosis relapse during therapy: inadequate (subtherapeutic) doses of direct oral anticoagulants, INR out of the target range during vitamin K antagonist therapy, undiagnosed malignant neoplasm, antiphospholipid syndrome.
What are the possible disease outcomes other than becoming chronic or fatal?
In addition to transition into a chronic form and death, disease outcomes include:
- recovery — complete or incomplete;
- relapse — the reappearance or re-intensification of disease symptoms after their elimination or substantial alleviation;
- remission — a period of temporary alleviation or elimination of disease signs; incomplete remission — temporary alleviation of symptoms, complete — temporary elimination of symptoms;
- complication — a pathological process developing against the background of the underlying disease, but not mandatory for it.
Relapse — "Re" (again) + "Cidiv" (to sit/fall): the disease "settles" on the body again. Remission — "Re" (again) + "Mission" (mission possible): the disease temporarily retreats.
Class and exam questions
Are the symptoms of a relapse always identical to the primary ones?
In most cases, yes. However, sometimes the clinical picture may change, as, for example, in chronic myeloid leukemia, where signs of anemia may come to the forefront.
What is the difference between complete and incomplete remission?
In complete remission, the signs of the disease temporarily disappear completely, whereas in incomplete remission, they only lessen.
Is a complication a mandatory part of the disease?
No, a complication is a pathological process developing against the background of the underlying disease, but not mandatory for it.
What else to study on this topic
- Mechanisms of transition from remission to relapse.
- Differential diagnosis of relapse and exacerbation.
- The role of pathogenetic links in the development of complications.
- Criteria for assessing the stability of remission in various nosologies.
- The impact of therapy on the frequency of relapses.
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