A Case of Relapsing Polychondritis

Lee, Dong Hwan; Kwon, So Jeong; Park, Jin Seouk; Woo, Chang Keun; Lee, Chang Ki; Hwang, Joong Ha; Lee, Byung Ki; Lee, Choong Ki

Abstract

Relapsing polychondritis is an uncommon disease manifested by episodes of progressive inflammation and destruction of cartilage. While the cause remains unknown, an autoimmune pathogenesis appears likely. Characteristic features include auricular chondritis, arthritis, nasal chondritis, ocular inflammation, respiratory tract involvement and audiovestibular damage. The clinical course of patients may vary from a relatively benign illness free of clinically evident visceral involvement, to one of episodic or smoldering activity with variable intensity, to a f ulminant illness and death within months of diagnosis. Dapsone, corticosteroid and immunosuppressive agent remain the effective therapies. We have experienced a case of relapsing polychondritis and active pulmonary tuberculosis in a 69-year-old man. He suffered from arthralgia and swelling of joints for several months on the first admission and initially was diagnosed as pseudogout based on polyarthritis and chondrocalcinosis of right knee joint. During follow-up, chondritis of both auricles and nose, which was proved by the biosy of right auricle, and relapse of polyarthritis were developed. His spu tum smear for acid-fast bacillus was postive on the second admission. Then he was diagnosed as relapsing polychondritis and active pulmonary tuberculosis and has achieved improvement with medication of dapsone and antituberculosis drugs according to susceptability test during followed-up. Thus we report this case with literature review.