Face of rarity : relapsing polychrondritis

Publication Date

2014

Document Type

Research

Abstract

A 44 year old Filipino Chinese male presented with pain, swelling and erythema of both ears, afternoon fever, cough, and hoarseness of voice. He underwent several laboratory tests, including work-up for tuberculosis. Different antibiotics were given but there was gradual resolution of ear pains and swelling and persistence of fever and hoarseness. At the 6th month of illness, he developed swelling of the right ankle. On consult with a rheumatologist, the diagnosis was relapsing polychondritis. He fulfilled the following modified Mc Adam's criteria for the diagnosis of relapsing polychondritis: 1) recurrent chondritis of both auricles; (2) nonerosive inflammatory arthritis; (3) chondritis of nasal cartilage; and (4) inflammation of ocular structures, including conjunctivitis, keratitis, scleritis/episcleritis, and/or uveitiis. There was resolution of fever, hoarseness and cough, and joint pains upon initiation of steroids and methotrexate. The rarity and varid presentations of relapsing polychondritis increase the possibility of it being missed. This case can increase physicians' awareness and perhaps improve treatment of the condition.

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