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Polychondritis Recidivans – A Case Report with a Review of the Literature

Received: 16 November 2023    Accepted: 4 December 2023    Published: 11 December 2023
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Abstract

Polychondritis recidivans is a rare immune-mediated autoimmune, multisystemic disease. It proceeds with recurrent inflammation of both cartilage tissue, mainly the ears, nose, larynx, tracheobronchial tree, ribs and joints, as well as the proteoglycan-rich tissues of the heart valves, blood vessels and eyes. The clinical picture is diverse. Symptoms often overlap with other diseases and diagnosis is delayed. Late diagnosis is the main cause of complications, and life-threatening damage to the affected structures. Polychondritis recidivans may be self-contained or associated with other autoimmune diseases, vasculitis, or hematological disorders. The diagnosis is clinical. The main manifestation of diagnostic value is chondritis with sequential or simultaneous involvement of several cartilage organs. There is no specific laboratory test for the disease. A cornerstone of therapy is glucocorticoids. With severe course, immunosuppressants are also used, and recently biological agents. We describe a case of a 51-year-old woman with repeated recurrences of moving inflammation of the ear cartilage, accompanied by arthritis, severely reduced hearing, hoarseness, conjunctivitis and episcleritis, and CNS symptoms. Blood tests showed leukocytosis and elevated C-reactive protein. Polychondritis recidivans is diagnosed based on the diagnostic criteria of L. P. McAdam et al., J. M. Damiani and H. L. Levine and C. J. Michet et al. Dramatic improvement from methylprednisolone treatment supported the diagnosis. An overview of the epidemiology, pathogenesis, clinical picture, complications, laboratory and imaging diagnostic methods, and treatment of polychondritis recidivans are presented.

Published in International Journal of Clinical Dermatology (Volume 6, Issue 2)
DOI 10.11648/j.ijcd.20230602.15
Page(s) 33-38
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Polychondritis, Recidivans, Epidemiology, Pathogenesis, Clinical Picture, Paraclinical Studies, Treatment

References
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  • APA Style

    Yungareva, I., Broshtilova, V., Trenovski, A., Velevska, Y., Vatov, P., et al. (2023). Polychondritis Recidivans – A Case Report with a Review of the Literature. International Journal of Clinical Dermatology, 6(2), 33-38. https://doi.org/10.11648/j.ijcd.20230602.15

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    ACS Style

    Yungareva, I.; Broshtilova, V.; Trenovski, A.; Velevska, Y.; Vatov, P., et al. Polychondritis Recidivans – A Case Report with a Review of the Literature. Int. J. Clin. Dermatol. 2023, 6(2), 33-38. doi: 10.11648/j.ijcd.20230602.15

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    AMA Style

    Yungareva I, Broshtilova V, Trenovski A, Velevska Y, Vatov P, et al. Polychondritis Recidivans – A Case Report with a Review of the Literature. Int J Clin Dermatol. 2023;6(2):33-38. doi: 10.11648/j.ijcd.20230602.15

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  • @article{10.11648/j.ijcd.20230602.15,
      author = {Irina Yungareva and Valentina Broshtilova and Aleksandar Trenovski and Yoanna Velevska and Petar Vatov and Sonya Marina},
      title = {Polychondritis Recidivans – A Case Report with a Review of the Literature},
      journal = {International Journal of Clinical Dermatology},
      volume = {6},
      number = {2},
      pages = {33-38},
      doi = {10.11648/j.ijcd.20230602.15},
      url = {https://doi.org/10.11648/j.ijcd.20230602.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20230602.15},
      abstract = {Polychondritis recidivans is a rare immune-mediated autoimmune, multisystemic disease. It proceeds with recurrent inflammation of both cartilage tissue, mainly the ears, nose, larynx, tracheobronchial tree, ribs and joints, as well as the proteoglycan-rich tissues of the heart valves, blood vessels and eyes. The clinical picture is diverse. Symptoms often overlap with other diseases and diagnosis is delayed. Late diagnosis is the main cause of complications, and life-threatening damage to the affected structures. Polychondritis recidivans may be self-contained or associated with other autoimmune diseases, vasculitis, or hematological disorders. The diagnosis is clinical. The main manifestation of diagnostic value is chondritis with sequential or simultaneous involvement of several cartilage organs. There is no specific laboratory test for the disease. A cornerstone of therapy is glucocorticoids. With severe course, immunosuppressants are also used, and recently biological agents. We describe a case of a 51-year-old woman with repeated recurrences of moving inflammation of the ear cartilage, accompanied by arthritis, severely reduced hearing, hoarseness, conjunctivitis and episcleritis, and CNS symptoms. Blood tests showed leukocytosis and elevated C-reactive protein. Polychondritis recidivans is diagnosed based on the diagnostic criteria of L. P. McAdam et al., J. M. Damiani and H. L. Levine and C. J. Michet et al. Dramatic improvement from methylprednisolone treatment supported the diagnosis. An overview of the epidemiology, pathogenesis, clinical picture, complications, laboratory and imaging diagnostic methods, and treatment of polychondritis recidivans are presented.
    },
     year = {2023}
    }
    

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    T1  - Polychondritis Recidivans – A Case Report with a Review of the Literature
    AU  - Irina Yungareva
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    AB  - Polychondritis recidivans is a rare immune-mediated autoimmune, multisystemic disease. It proceeds with recurrent inflammation of both cartilage tissue, mainly the ears, nose, larynx, tracheobronchial tree, ribs and joints, as well as the proteoglycan-rich tissues of the heart valves, blood vessels and eyes. The clinical picture is diverse. Symptoms often overlap with other diseases and diagnosis is delayed. Late diagnosis is the main cause of complications, and life-threatening damage to the affected structures. Polychondritis recidivans may be self-contained or associated with other autoimmune diseases, vasculitis, or hematological disorders. The diagnosis is clinical. The main manifestation of diagnostic value is chondritis with sequential or simultaneous involvement of several cartilage organs. There is no specific laboratory test for the disease. A cornerstone of therapy is glucocorticoids. With severe course, immunosuppressants are also used, and recently biological agents. We describe a case of a 51-year-old woman with repeated recurrences of moving inflammation of the ear cartilage, accompanied by arthritis, severely reduced hearing, hoarseness, conjunctivitis and episcleritis, and CNS symptoms. Blood tests showed leukocytosis and elevated C-reactive protein. Polychondritis recidivans is diagnosed based on the diagnostic criteria of L. P. McAdam et al., J. M. Damiani and H. L. Levine and C. J. Michet et al. Dramatic improvement from methylprednisolone treatment supported the diagnosis. An overview of the epidemiology, pathogenesis, clinical picture, complications, laboratory and imaging diagnostic methods, and treatment of polychondritis recidivans are presented.
    
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Author Information
  • Department of Skin and Venereal Diseases, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

  • Department of Skin and Venereal Diseases, Eurohealth, Sofia, Bulgaria

  • Department of Anesthesiology and Intensive Care, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

  • Department of Infectious Diseases, Parasitology and Dermatovenereology, Medical University, Varna, Bulgaria

  • Department of Surgical Diseases, Unit of Urology, Medical University, Varna, Bulgaria

  • Department of Skin and Venereal Diseases, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

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