Relapsing polychondritis in a Latin American man

Area of Science:

• Rheumatology
• Immunology
• Case Report

Background:

• Relapsing polychondritis (RP) is a rare, systemic autoimmune disease characterized by progressive cartilage destruction.
• The disease affects various cartilaginous structures, including the ears, nose, joints, and respiratory tract.
• Limited data exists on RP presentation and management in Latin American populations.

Observation:

• A 35-year-old Latin American male presented with auricular chondritis, arthritis, nasal cartilage involvement, episcleritis, and respiratory tract chondritis.
• Initial treatment included high-dose systemic corticosteroids (prednisone) and topical ophthalmic agents.
• Despite treatment, the patient developed airway collapse requiring tracheostomy and was initiated on azathioprine.

Findings:

• Systemic corticosteroids are the cornerstone of RP treatment.
• Immunosuppressive agents like azathioprine serve as effective adjuvants to reduce steroid dosage and manage severe disease.
• Dapsone monotherapy is emerging as a potentially effective alternative, possibly reducing the need for high-dose steroids and immunosuppressants.

Implications:

• This case highlights the importance of recognizing relapsing polychondritis in diverse ethnic groups.
• Effective management strategies involve a combination of corticosteroids and immunosuppressants for severe or progressive cases.
• Exploring alternative treatments like dapsone could offer new therapeutic avenues for relapsing polychondritis patients.