Beyond the Earlobe: Navigating the Complexities of Relapsing Polychondritis

A 27-year-old male with no significant past medical history presented with recurrent swelling and pain on the right superior crus of the antihelix initially misdiagnosed as a skin infection. Despite adherence to antibiotic treatment, his condition showed no improvement, leading to further investigation. The patient's detailed clinical examination, family history devoid of autoimmune disorders, and persistent auricular inflammation prompted a reconsideration of the diagnosis. A subsequent biopsy that captured cartilage revealed auricular chondritis, perichondrial inflammation, degeneration of cartilage, and infiltration by inflammatory cells, all of which have been clinically associated with relapsing polychondritis (RP). Relapsing polychondritis (RP) is a rare autoimmune disorder characterized by recurrent inflammation of cartilaginous structures, often leading to progressive anatomical deformation and functional impairment. While RP's pathogenesis involves complex autoimmune mechanisms, its diagnosis is challenging due to its varied clinical presentations. This case highlights the diagnostic challenges of atypical presentations of RP and underscores the importance of considering RP in differential diagnoses of persistent auricular inflammation. It also emphasizes the role of corticosteroids in managing RP and the potential for novel therapeutic pathways, such as Janus kinase inhibitors, in treatment. The case contributes to a deeper understanding of RP's clinical spectrum and management strategies, stressing the need for heightened clinical suspicion in similar atypical cases.

Subglottic Mass as Isolated Manifestation of Relapsing Polychondritis at Presentation

Relapsing polychondritis (RP) is a rare systemic disease that is characterized by recurrent episodic inflammation of the cartilaginous structures of the body, resulting in their progressive destruction and subsequent replacement with fibrotic scar. We present a case of RP that initially manifested with subglottic involvement and we propose an innovative strategy for the treatment for laryngeal RP in phase of active inflammation. A multidisciplinary approach (rheumatologist, otolaryngologist, immunologist, internist, cardiologist, etc) and adequate follow-up are essential. The timeliness of the diagnosis is fundamental to contain the destructive effects on the cartilages involved.

A case of polychondritis in a patient with Behçet's disease

Polychondritis is an inflammatory disorder that affects various catilagenous structures, and the clinical features include auricular, nasal and respiratory tract chondritis. It also involves the eyes, audiovestibular apparatus, joints and vascular structures. Polychondritis can be associated with several rheumatologic diseases such as systemic lupus erythematosus, rheumatoid arthritis and systemic vasculitis. However, polychondritis is a rare complication of Behçet's disease (BD) and only ten cases with combined BD and polychondritis have been reported on around the world. In this report, we describe a 40-year-old Korean man with BD who suffered from polychondritis that manifested as bilateral auricular chondritis, conjunctivitis and arthritis.

Autologous stem-cell transplantation in refractory autoimmune diseases after in vivo immunoablation and ex vivo depletion of mononuclear cells

Autoimmune diseases that are resistant to conventional treatment cause severe morbidity and even mortality. In the present study we demonstrate that complete remissions can be achieved in refractory polychondritis and systemic lupus erythematosus (SLE), even at advanced stage, with the use of autologous stem-cell transplantation (SCT). Remissions persisted after reconstitution of the immune system. In the treatment of advanced systemic sclerosis (SSc), stable disease may be achieved with autologous SCT.