J Rheum Dis.  2014 Jun;21(3):166-169. 10.4078/jrd.2014.21.3.166.

A Case of Relapsing Polychondritis Improved by Infliximab Treatment

• Lee SJ
• Yang JA
• Park JW
• Ko DJ
• Kwon HM
• Moon JY
• Kim YK
• Choi YH
• Lee EY

• KMID: 2297531
• DOI: http://doi.org/10.4078/jrd.2014.21.3.166

Abstract

Relapsing polychondritis is an episodic, systemic inflammation of the cartilage with unknown autoimmune etiology. It leads to the destruction of cartilaginous structures of the ear, eye, nose, respiratory tract, joints, skin, and heart valve, and its presented symptoms are diverse. It can be improved mainly by corticosteroid or immunosuppressive agents. Recently, the use of biologic agents (TNF inhibitors, rituximab, tocilizumab et al) was reported from abroad. However, there is no reported case of relapsing polychondritis, which is treated by biologic agents in Korea. We report this first case of refractory relapsing polychondritis, which was improved with a treatment of Infliximab.

Keyword

Relapsing polychondritis; Infliximab

MeSH Terms

Biological Factors
Cartilage
Ear
Heart Valves
Immunosuppressive Agents
Inflammation
Joints
Korea
Nose
Polychondritis, Relapsing*
Respiratory System
Skin
Infliximab
Rituximab
Biological Factors
Immunosuppressive Agents

Figure

• 

  Figure 1. Photomicrograph of left auricular cartilage Biopsy. Auricular cartilage showing degeneration with vacuolization of chondrocyte, fibrosis (H&E stain, A ×100, B ×200).

• 

  Figure 2. Photograph of right auricle in the patient. Left photo is the patient's right ear before the infliximab infusion. It shows swelling and redness of the ear, but sparing of the earlobe (A). Rigtht photo is the patient's right ear after the infliximab infusion. It shows no swelling, redness of the ear (B).

• 

  Figure 3. Timeline of patient's medication and serum C-reactive protein (CRP). The patient received methylprednisolone 60 mg/d for 6 days when he had first flare (empty arrow). The patient received infliximab when he had second flare (filled arrow).

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