Relapsing polychondritis misdiagnosed and treated as a “soft tissue infection” and a brief review of diagnostic clinical clues

Abstract

Relapsing polychondritis (RPC) is a rare immune-mediated disease, which targets particularly the cartilaginous tissue. At the initial stages of RPC, recurring mild-inflammatory attacks targeting the ears, nose, eyes, joints and respiratory tract can be observed but as the disease progresses, aortic and/or mitral valvular regurgitation (AR/MR) or life-threatening tracheobronchomalacia (due to involvement of aortic, mitral valves and/or trachea) may occur, as well as severe destruction of the ear, nose, etc. RPC may coexist with other diseases, such as systemic vasculitides, Graves disease or myelodysplastic syndrome. Establishing an early diagnosis is of utmost importance to prevent the development of AR/MR, or tracheobronchomalacia by preserving the cartilage tissue and also to diagnose a possible coexisting disease. Patients, particularly at the initial stages of the disease may object to a skin biopsy due to concerns for visible scars. Therefore, a good grasp of RPC's clinical symptoms may facilitate to establish an early diagnosis.