Relapsing polychondritis in a Latin American man

Abstract

The first known reported case of relapsing polychondritis in a Latin American man is presented. The 35-year-old man, demonstrating auricular chondritis, arthritis, nasal cartilage involvement, episcleritis and respiratory tract chondritis, was admitted to the hospital and treated with 60 mg of prednisone daily, prednisolone acetate 1% ophthalmic drops every waking hour and homatropine hydrobromide 5% ophthalmic drops twice daily. After discharge from the hospital, he received 30 to 60 mg of prednisone daily and prednisolone acetate 1% ophthalmic drops twic daily for about 18 months. A permanent trachestomy was placed, azathioprine, 150 mg daily, was given and prednisone dosage was tapered to 25 mg daily when the patient subsequently was hospitalized for colapsed airway and Cushing's syndrome. The classic symptoms, pathogenesis and treatment of the disease are reviewed. Systemic corticosteroids are the drugs of choice in relapsing polychondritis, with immunosuppressive drugs, azathioprine in particular, being used as adjuvants to lower steroid dosage requirements and to achieve greater control of symptoms in patients with the severe progressive disease. Treatment of the disease with dapsone alone is promising and may offer an alternative to high-dose steroids and immunosuppressive therapy.