Relapsing polychondritis (RP) is a rare autoimmune disease characterized by repeated episodes of inflammation of cartilage of different parts of the body.  These recurrent episodes of inflammation throughout the course of the disease may result in cartilage damage and loss.  The exact cause of RP is unknown.  Inflammation is due to the result of an exaggerated immune response to our own cartilage.  Relapsing polychondritis affects males and females equally and occurs most often between the ages of 40-60 years.

Although any cartilage in the body can be affected in patients with RP, areas most often involved include the ears and nose.  It can affect the entire outer part of the ear, except the earlobe.  The ears become red, warm, painful upon touch, and swollen.

The episode generally lasts a few days or more, rarely a few weeks.  It resolves spontaneously and recurs at various intervals.  After repeated inflammation, cartilage can become damaged and ears deformed.  The inflammation of the nose involves the bridge.  This inflammation can result in collapse of the nasal septum resulting in a saddle-nose deformity.  Although painless, the damage is irreversible.  Joint pain or even joint swelling is common in patients with RP.

RP can also affect laryngeal, tracheal, and bronchial cartilage.   Patients experience hoarseness or loss of voice.  Recurrent laryngeal inflammation may result in permanent laryngeal stenosis and difficulty breathing.  Tracheal or bronchial narrowing can cause wheezing, dyspnea, or even respiratory failure.  Some patients experience chest wall pain due to costochondritis.  Cardiac valves can also be affected.  Severe cases of cardiopulmonary involvement can be severe and life-threating.

RP can also cause occular inflammation such as episcleritis or scleritis.  Patients may experience red and painful eyes and even blurred vision.  The long-term outlook of people with RP varies from person to person depending on the severity and internal organ involvement.  Some forms of impairment such blurred vision, hearing loss, loss of balance, and cardiopulmonary disease are common in the later stage of RP.  Respiratory complications such as windpipe collapse and infections are the most common causes of RP death, followed by cardiac complications.

The primary goals of treatment for people with relapsing polychondritis (RP) are symptom relief and prevention of damage to the structure of the cartilage.  Prednisone is used to decrease the severity, frequency, and duration of relapses. Colchicine or Dapson can also be used in patients with mild RP.  For moderate to severe cases of RP, Methotrexate, Azathioprine, Cyclosporine or even biologics are used to suppress exaggerated immune response. Even though relapsing polychondritis can be a debilitating illness, with early diagnosis and proper treatment, severe complications can be treated and even prevented.

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