Two Cases of Relapsing Polychondritis that Emerged with Larynx lesions

Abstract

Relapsing polychondritis is a relatively rare disease that attacks the cartilage and connective tissue. We will herein report 2 cases of RP arising in the larynx.

Case 1: A 59-year-old woman visited our hospital with roughness of voice, wheezing, and dyspnea. An endoscopic examination revealed a suspected submucosal tumor from the left arytenoid region to the false vocal cord. We performed tracheostomy and a biopsy of the swollen mucosa; however, no tumor was found. We then performed a biopsy of the thyroid cartilage, which showed inflammation. A biopsy of the auricular cartilage also showed inflammation, and relapsing polychondritis was diagnosed.

Case 2: A 79-year-old woman with worsening dyspnea visited our hospital. Endoscopic examination revealed subglottic stenosis. We performed tracheostomy and a biopsy of the auricular cartilage; however, no inflammation was found. Dyspnea disappeared spontaneously. Nine months after the first visit, she presented strong dyspnea. An endoscopic examination revealed stenosis and mucous membrane swelling from the part of the trachea that was caudal to the stoma to the bronchus; however, no inflammation was detected in the biopsy of the bronchial mucosa. Twelve months after the first visit, the both sides of auricle swelled, and relapsing polychondritis was diagnosed. Since it was not always easy to indentify inflammatory in case 2, we should consider other clinical findings, the effectiveness of steroids, and auricular cartilage biopsy, if necessary, for the early diagnosis of relapsing polytchondritis in order to reduce the risk for respiratory failure.