Relapsing Polychondritis Complicated by Tracheabronchial Stenosis: A Case Report and Literature Review

Abstract

Relapsing polychondritis is an autoimmune disease of the cartilage. The most common manifestations are scleritis, and chondritis of the ear and nose. If the disease is not treated well, inflammation of the cartilage in the trachea or bronchi may occur and develop into a rare life-threatening complication with severe airway narrowing, obstruction, or sudden onset of airway collapse. As the clinical manifestations of relapsing polychondritis do not usually present simultaneously, this disease is easily subjected to misdiagnosis or delayed diagnosis. We herein report a 24-year-old patient who was initially afflicted with chondritis of the ear lobes and scleritis, but was eventually complicated with severe tracheal and bronchial stenosis 6 months after inadequate immunotherapy. Computed tomography studies of the airway showed severe narrowing in the sub-glottic area (70% stenosis) and moderate narrowing in the trachea and bronchi. The affected cartilage of the trachea was also found to be swollen. After being treated with high-dose glucocorticosteroid and immunosuppressant drugs (azathioprine) for 1 month, the ear chondritis and scleritis were well controlled, but the airway stenosis remained unchanged and required surgery to prevent airway obstruction. We think that increased awareness of this disease may help us to diagnose it earlier and treat it more promptly, so as to prevent airway stenosis.