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  • Poster presentation
  • Open Access

MAGIC- is it for real?

  • 1,
  • 2,
  • 3,
  • 1,
  • 3 and
  • 1, 3
Pediatric Rheumatology201513 (Suppl 1) :P156

  • Published:


  • Vasculitis
  • Colchicine
  • Aortic Aneurysm
  • Referral Centre
  • Rare Condition


MAGIC syndrome, an acronym for mouth and genital ulcers with inflammed cartilage, is a rare condition described in 1985 [1]. About 20 cases have been reported [2], and its existence is challenged, as it could be just a mere association of Bechet's disease (BD) with relapsing polychondritis (RP) [3]. Other authors, however, consider it a distinct entity with higher risk of aortic aneurysms [4]. We tried to find out whether this syndrome is a true nosologic entity.


We retrospectively reviewed our tertiary referral centre's database from 2000 to 2015 in order to identify the cases of RP and BD. All patients fulfilled the International Criteria for BD [5] and the Damiani-Levine criteria for RP [6].


Three cases have been identified, all diagnosed with MAGIC's syndrome since the first presentation. No other case evolved into MAGIC after an initial diagnosis of RP or BD. Hematological screening was negative in all patients; one had gastrointestinal vasculitis and another one panniculitis. No one in our series had eye or CNS involvement. Aortic aneurysms were absent (as yet) in the 2 patients searched for. Azathioprine, colchicine and corticotherapy were employed effectively in all patients.
Table 1

Clinical features of MAGIC patients in our series


Sex, age

Clinical features


Aortic involvement



F, 63

oral aphtae since youth; genital aphtae, deep vein thrombosis, migratory seronegative polyarthritis, reccurent bilateral auricular chondritis, wheesing



Lost to follow-up (after 2 years)


F, 35

bipolar aphtae, asymmetric sacroiliitis, acneiform rash, intermittent seronegative polyarthritis, gastrointestinal involvement, bilateral auricular and nasal chondritisANA positive, dsDNA negative



Lost to follow-up (after 3 years- emigrated)


M, 2

bipolar aphtae, pseudofolliculitis, erythema nodosum, arthritis, panniculitis, recurrent auricular chondritis, nasal chondritis, positive cartilage biopsy



Rare chondritis flares

CS=corticosteroids, Col=colchicine, AZA=azathioprine


RP and BD have overlapping features and may share pathogenetic mechanisms. The same time of onset of the main MAGIC clinical features could favour the classification of the disease as distinct from RP and BD alone. However, in our small and incompletely followed-up series aortic aneurysms were not seen, like in other MAGIC cases reported. An aortic follow-up is nevertheless advisable, as in any RP.

Authors’ Affiliations

Emergency Clinical County Hospital Cluj, Rheumatology, Cluj-Napoca, Romania
Emergency County Hospital Deva, Rheumatology, Deva, Romania
“Iuliu Hatieganu” University of Medicne and Pharmacy Cluj, Rheumatology, Cluj-Napoca, Romania


  1. Firestein GS, Gruber E, Weisman MH, Zvaifler NJ, Barber J, O'Duffy JD: Mouth and genital ulcers with inflamed cartilage: MAGIC syndrome. Am J Med. 1985, 79 (1): 65-72. 10.1016/0002-9343(85)90547-9.View ArticlePubMedGoogle Scholar
  2. Wajed J, Kiely P: 19. Could it be Magic?. Rheumatology. 2011, 50 (Suppl 3): iii43-iii50.Google Scholar
  3. Kotter J, Deuter C, Gunaydin I, Zierhut M: MAGIC or not MAGIC (mouth and genital ulcers with inflamed cartilage) syndrome really exists? A case report and review of the literature. Clin Exp Rheumatol. 2006, 24 (5 Suppl 42): S108-S112.PubMedGoogle Scholar
  4. Hidalgo-Tenorio C, Sabio-Sanchez JM, Linares PJ, Salmeron LM, Ros-die E, Jimenez-Alonso J: Magic syndrome and true aortic aneurysm. Clin Rheumatol. 2008, 27 (1): 115-117.View ArticlePubMedGoogle Scholar
  5. Kronborg C, Mahar PD, Kelly R: Should we keep changing the diagnostic criteria for Behcet's disease?. Dermatology. 2014, 228 (1): 1-4. 10.1159/000355481.View ArticlePubMedGoogle Scholar
  6. Damiani JM, Levine HL: Relapsing polychondritis- report of ten cases. Laryngoscope. 1979, 89 (6 Pt 1): 929-946.PubMedGoogle Scholar


© Damian et al. 2015

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