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Relapsing Polychondritis Presenting With Hoarseness and Multisystem Involvement: A Diagnostic and Therapeutic
Shamilka De Silva1, Monika De Silva2, Pradeep K De Silva3
1Internal Medicine, National Hospital of Sri Lanka, Colombo, LKA.
Abstract:
Relapsing polychondritis (RP) is a rare autoimmune disorder characterized by recurrent inflammation of cartilaginous tissues throughout the body, particularly the ears, nose, eyes, joints, and the respiratory tract. We present a case of a 68-year-old female without previous comorbidities who presented with gradually progressive hoarseness of voice and inflammatory polyarthritis, nasal and ear involvement eventually leading to the diagnosis of RP with concurrent osteoporosis. The diagnosis was made based on Modified McAdam criteria, highlighting the significance of clinical evaluation in guiding diagnosis and treatment decisions. Treatment with intravenous cyclophosphamide and oral prednisolone resulted in significant improvement in symptoms and inflammatory markers. Osteoporosis was managed with intravenous zoledronic acid. This case underscores the importance of considering RP in the differential diagnosis of patients presenting with hoarseness of voice and multisystem involvement, even in the absence of histological confirmation.
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