Relapsing Polychondritis Initially Presenting with Hoarseness and Difficulty Breathing in a 21-Year-Old Male

• Main Authors: Paula Francezca Padua, William L. Lim
• Format: Article
• Language: English
• Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2016-11-01
• Series: Philippine Journal of Otolaryngology Head and Neck Surgery
• Subjects: Polychondritis, Relapsing; airway involvement; imaging
• Online Access: https://pjohns.pso-hns.org/index.php/pjohns/article/view/237

Objective:       To present a case of relapsing polychondritis initially presenting with hoarseness and difficulty breathing and to discuss the diagnostic criteria and typical CT scan findings of relapsing polychondritis. Design:                       Case Report Setting:                       Tertiary Private Hospital in Metro Manila Case Report:              A 21-year-old man who was initially managed as a case of bronchial asthma for persistent hoarseness and recurrent difficulty breathing was found to have severe laryngeal edema on endoscopy, and soft tissue expansion of the cricoid cartilage with calcifications and irregular first tracheal ring on CT scan.  He also had recurrent eye redness and developed bilateral aural inflammation, and was subsequently diagnosed to have relapsing polychondritis. Conclusion:                Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation and eventual destruction of cartilage throughout the body. Typical manifestations may not always be present, causing a delay in diagnosis.  It should be considered in patients with intractable respiratory symptoms not responsive to treatment for upper respiratory tract infections or asthma. A CT scan may reveal signs of cartilage destruction and help in diagnosis.       Keywords:     Polychondritis, Relapsing; airway involvement; imaging