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Polish Archives of Internal Medicine 2009-Oct

Relapsing polychondritis: case report and literature review.

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Krzysztof Pol
Mirosław Jarosz

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Abstract

Relapsing polychondritis (RP) is a rare connective tissue disease which affects cartilaginous tissues of the nose, earlobes, respiratory tract, and joints, as well as proteoglycan-rich tissues including the media of the arteries, the conjunctiva and sclera of the eye. The disease is most common in patients aged 40-60 years. It may for a long time cause unspecific signs (fever, malaise), which may cause a significant delay in establishing the diagnosis and initiating the ppropriate treatment. The mean time from symptom onset to diagnosis is 2.9 years. Steroids are the mainstay of therapy, but methotrexate and dapsone may also be beneficial in some patients. A case of RP presenting with fever, anemia, fatigue, arthritis, conjunctivitis, and auricular deformation is described. There were signs and symptoms suggestive of an infectious disease but no infection had been found, and despite tentative administration of antibiotics, the patient's condition steadily deteriorated. Eventually, the diagnosis was established based on McAdam's criteria. After intiating steroid therapy, the patient's condition improved significantly. We discuss the diagnostic criteria and treatment of this rare disease.

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