What Is Relapsing Polychondritis?
Relapsing polychondritis (RP) is a rare disease that causes inflammation of your cartilage and other tissues in your body. If you have painful joints and notice changes in your ears or nose, you might have this condition.
Inflammation is your body’s way to fight disease or injury. When your immune system thinks there’s a problem (like a virus or bacteria), it releases certain cells in your blood, and more blood flows to the affected area. That can cause redness, warmth, swelling, or pain.
The pain from RP usually comes on suddenly, and it can happen to both men and women, and to people of all ages. But it’s more likely to start between the ages of 40 and 60.
It affects people in different ways. Some get a mild case of RP once in a while, and the symptoms go away on their own. Others have lots of pain and more frequent attacks.
Because it can affect key organs, RP can lead to serious illness and can be life-threatening.
Relapsing Polychondritis Symptoms
The disease mostly affects cartilage (firm but flexible tissue) in your ears and joints. It also may show up in your nose, ribs, spine, and windpipe. It can affect any area where the tissue is similar to cartilage, like your eyes, heart, skin, kidney, ribs, blood vessels, and nervous system.
Common signs of relapsing polychondritis include:
- A dip in the bridge of your nose ("saddle nose" or "pug nose")
- Ear pain and redness
- Red, painful, and swollen eyes
- Painful, swollen joints (hands, fingers, shoulders, elbows, knees, ankles, toes, pelvis) that may or may not happen along with arthritis
- Rib pain
- Throat or neck pain
- Trouble breathing and speaking
- Trouble swallowing
- Rashes
People with this condition may also have other inflammatory diseases like vasculitis or ankylosing spondylitis. They also may have another autoimmune disease like lupus.
Depending on where RP affects you, it can also cause problems with a heart valve or kidney issues. If RP affects your inner ear, you could feel sick to your stomach or have trouble with hearing and balance.
If the disease gets into your windpipe, it can cause a cough and make it hard to breathe or swallow. You also can have severe RP pain in your breastbone and ribs.
Relapsing Polychondritis Causes
Doctors don’t know what causes RP. Some think a certain gene may make you more likely to get it, but it doesn’t run in families.
It’s considered an autoimmune disorder. That means your immune system attacks healthy tissue by mistake. Researchers think some cases might be triggered by stress or things in the environment.
Relapsing Polychondritis Diagnosis
There isn’t a test for RP. Your doctor will examine you and ask questions about your symptoms. You might get a blood test for signs of inflammation. X-rays can make the affected areas show up better.
To find out for sure if you have RP, your doctor might look for three or more of these:
- Inflammation of the cartilage in both your ears
- Inflammation of the cartilage in your nose
- Inflammation of the cartilage in your airway
- Arthritis in five or more joints at the same time
- Hearing or balance problems (vertigo, hearing loss, tinnitus)
- Eye inflammation (conjunctivitis, episcleritis, scleritis, and/or uveitis)
In some cases, your doctor may want to take a small amount of tissue to look at under a microscope. This is known as a biopsy.
Depending on how the disease affects you, you might need to see a specialist. This could be an expert in autoimmune disorders (rheumatologist), heart problems (cardiologist), or pain management.
Relapsing Polychondritis Treatment
There’s no cure for RP, but your doctor can help you feel better and save your cartilage with:
- Anti-inflammatories (like Motrin or Advil) can help with pain, especially for people who have a mild case of RP.
- Steroids (like prednisone) or other kinds of drugs to help with inflammation.
- Stronger drugs that slow down your immune system. And depending on how serious your case is, and which organs are affected, you might need surgery to fix a damaged heart valve or put in a breathing tube.
Relapsing Polychondritis Outlook
The long-term outlook for RP is different for each person. The condition will get worse over time. Vision and hearing loss, heart and lung disease, and balance problems are all common in the later stages of the condition.
Serious cases of RP can be deadly, but survival rates have improved a great deal over the years.
