26th February 2025

Relapsing polychondritis

This is a rare autoinflammatory disorder which causes immune-mediated destruction of cartilage. 

Clinical features include:

• Auricular cartilage is the most commonly affected, followed by nasal cartilage. 
• Episcleritis and anterior scleritis commonly co-exist. 
• Seronegative asymmetric polyarthritis affecting the small joints is a common presenting symptom. 
• Laryngotracheal cartilage is affected in up to 50% and can present with cough, hoarseness or stridor. Other respiratory manifestations include recurrent lower respiratory tract infections. 
• Cardiac involvement is the second most common cause of mortality after respiratory causes. Aortic regurgitation secondary to aortic root dilatation is the most common cardiac feature. 
• Other systems, such as the kidneys, GI tract, and CNS can be involved, but this is rarer.

Treatment varies widely, from NSAIDs and colchicine to biologics such as anti-TNF agents, depending on severity.