Relapsing polychondritis awareness

Overview

Relapsing polychondritis (pronounced ree-LAP-sing pol-ee-kon-DRY-tis) is a rare condition where your body's immune system attacks its own cartilage – the tough but flexible tissue found in your ears, nose, and airways. This causes repeated episodes of painful swelling and redness. It can also affect other parts of the body, such as the joints, eyes, and blood vessels.

No, relapsing polychondritis is a rare condition. It affects only about 1 in every 100,000 people.

It most commonly affects adults between the ages of 40 and 60, but it can occur at any age. Men and women are affected about equally, though some studies suggest it may be slightly more common in women.

Symptoms

Common symptoms

• Red, swollen, and painful ears – the outer ear becomes inflamed and may feel tender to the touch.
• A red, swollen, or tender nose – the cartilage of the nose may feel sore and change shape over time (saddle nose).
• Pain and swelling in the joints (arthritis), often in the hands, wrists, knees, or ankles.
• Eye inflammation – redness, pain, sensitivity to light, or blurred vision.
• Hoarseness, a cough, or a feeling of tightness in the throat.
• Fever, fatigue, and weight loss during flare-ups.

Symptoms in children

• Relapsing polychondritis is very rare in children. Symptoms are similar to adults but may be harder to recognize.
• Children often show ear and joint inflammation, and may have a saddle nose deformity earlier.
• They may also have growth problems or delayed puberty due to chronic illness.

Symptoms in older adults

• Symptoms are the same as in younger adults, but older adults may have more severe or frequent flares.
• Breathing problems can be more dangerous because of age-related changes in the lungs and airways.
• Older adults may also have other chronic conditions that complicate treatment.

Causes

Main causes

• Relapsing polychondritis is an autoimmune disorder – the immune system attacks the body's own cartilage.
• The exact reason this happens is not fully understood. It may be triggered by a combination of genetic factors and an environmental trigger, such as an infection or injury.
• It is not contagious – you cannot catch it from someone else.

Risk factors

• Having certain genetic markers (HLA-DR4) may increase the risk.
• Other autoimmune diseases, such as rheumatoid arthritis, lupus, or vasculitis, may slightly raise the risk.
• Family history – though rare, it can run in families.

When to see a doctor

See a doctor urgently if:

• If you suddenly have trouble breathing, wheezing, or a feeling of throat tightness, call your local emergency number immediately.
• If you have severe eye pain, vision changes, or sensitivity to light, see a doctor or go to an urgent care centre right away.
• If you have a high fever with ear or nose swelling that is spreading.

Book a routine appointment if:

• If you have repeated episodes of ear or nose swelling that come and go.
• If you have joint pain and swelling that lasts more than a few days without a known cause.
• If you notice a change in the shape of your nose or a persistent hoarse voice.
• If you have chronic fatigue and unexplained weight loss along with other symptoms.

Diagnosis

There is no single test for relapsing polychondritis. Doctors usually diagnose it based on your medical history, physical exam, and a set of criteria that includes typical symptoms like ear and nose inflammation. Sometimes a biopsy (a small sample of cartilage) is taken to look for inflammation under a microscope.

Tests that may be done

• Blood tests to check for signs of inflammation (CRP, ESR) and autoimmune markers.
• Imaging tests like CT scans or MRI of the chest and airways if breathing symptoms are present.
• A biopsy of affected cartilage (usually from the ear or nose) to confirm the diagnosis.
• Eye exam if eye symptoms are present.

What to expect at your appointment

Diagnosis can take time because the symptoms are similar to other conditions. Your doctor may refer you to a specialist (rheumatologist). You may need repeated visits and tests. The key is to keep a symptom diary and share details with your healthcare team.

Treatment

Treatment aims to control inflammation, relieve symptoms, and prevent damage to cartilage and other organs. A team of specialists (rheumatologist, ENT doctor, eye doctor, etc.) usually manages the care. Treatment is tailored to each person's symptoms and severity.

Self-care at home

• Rest during flare-ups and pace your activities.
• Apply cold packs to swollen ears or joints to reduce pain and swelling.
• Protect your ears and nose from injury – avoid ear piercings and heavy earrings.
• Use a humidifier at home to keep your airways moist if you have cough or hoarseness.

Medical treatments

Doctors typically start with anti-inflammatory medicines to control mild symptoms. For more severe cases, they use medications that suppress the immune system. These may include pills or injections. In some cases, biologic therapies (a type of targeted treatment) are used. All treatments require close monitoring by a healthcare provider. Do not stop or change medications without consulting your doctor.

When is surgery considered?

Surgery may be needed if the airway becomes narrowed or if the nose collapses significantly. In rare cases, a tracheostomy (an opening in the windpipe) is done to help breathing. Joint surgery may be considered for severe damage. Surgery is not common and is reserved for specific complications.

Living with this condition

Living with relapsing polychondritis means managing flares and adjusting your routine. Keep a symptom diary to track what triggers your flares. Learn to recognise early signs of a flare, such as ear redness or joint ache, and rest early. Work with your healthcare team to create a treatment plan that fits your life.

Lifestyle tips

• Get enough rest and avoid overexertion.
• Manage stress through relaxation techniques like deep breathing or meditation.
• Avoid smoking and secondhand smoke – smoking can worsen airway inflammation.
• Protect your skin and joints from injury – use caution with activities that stress your ears or nose.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, and whole grains to support your immune system. There is no special diet for relapsing polychondritis. Gentle exercise like walking, swimming, or yoga can help maintain joint flexibility and overall health, but avoid high-impact activities during flares. Always check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Living with a chronic, rare condition can be stressful and may lead to anxiety or depression. It is normal to feel worried or frustrated. Talk to your doctor about your feelings – they can refer you to a counsellor or support group. Remember that mental health is just as important as physical health.

Prevention

There is no known way to prevent relapsing polychondritis because the exact cause is not understood. However, early diagnosis and treatment can help prevent flares and reduce the risk of complications.

Vaccines

Vaccines are important for overall health, but there is no vaccine for relapsing polychondritis itself. Make sure your vaccines are up to date, including the flu and pneumonia vaccines, as infections can sometimes trigger flares. Discuss with your doctor before getting any vaccine if you are on immune-suppressing medications.

Screening programmes

There is no routine screening test for relapsing polychondritis. If you have a family history or other autoimmune conditions, stay alert for symptoms and see your doctor promptly if they occur.

Complications

If left untreated

• Damage to the cartilage of the nose causing a permanent 'saddle nose' deformity.
• Narrowing of the airways (trachea and bronchi) leading to breathing problems.
• Damage to the heart valves or the aorta (the main artery) causing heart problems.
• Inflammation of the eyes leading to vision loss if not treated.
• Chronic joint damage and deformity.

Long-term outlook

With proper treatment, most people with relapsing polychondritis can manage their symptoms and maintain a good quality of life. The course of the disease varies – some have mild flares, others more severe. Serious complications are less common with early and consistent treatment. Many people live full lives with the condition.

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