A case of relapsing polychondritis

Relapsing polychondritis (RP) is a systemic disorder characterized by recurrent inflammation and degeneration of cartilage. A 49-year-old woman was admitted to our hospital with bilateral hearing loss and tinnitus. Physical examination revealed saddle nose and congestion of bulbar conjunctiva. Both tympanic membranes and external auditory canals were hyperemic. Her sedimentation rate was 30mm/hr and WBC 8370. Anti-nuclear antibody and anti-cartilage antibody were positive. The OKT4 OKT8 ratio in the peripheral blood was 4.17. Audiograms revealed both sensori-neural and conductive impairment. Biopsies of the nasal septum showed degeneration of cartilage, fibrosis and mononuclear cell infiltrates. Treatment with 1000mg Solu-Medrol for three days (every other day) resulted in dramatic improvement in hearing and tinnitus after a few days of treatment, suggesting excellent prospects of pulse therapy of steroid hormone in the treatment of RP.