A Case of Relapsing Polychondritis Improved by Infliximab Treatment

Sang Jin Lee; Ji Ae Yang; Jun Won Park; Dong Jin Ko; Hyun Mi Kwon; Jin Young Moon; Young Ki Kim; Young Hoon Choi; Eun Young Lee

doi:10.4078/jrd.2014.21.3.166

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Lee, Yang, Park, Ko, Kwon, Moon, Kim, Choi, and Lee: A Case of Relapsing Polychondritis Improved by Infliximab Treatment

Case Report

J Rheum Dis 2014;21(3):166-169.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.3.166

A Case of Relapsing Polychondritis Improved by Infliximab Treatment

Sang Jin Lee, Ji Ae Yang, Jun Won Park, Dong Jin Ko, Hyun Mi Kwon, Jin Young Moon, Young Ki Kim, Young Hoon Choi, Eun Young Lee

Department Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Corresponding to: Eun Young Lee, Department Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 110-744, Korea. E-mail: elee@snu.ac.kr

Received 9 May 2013 Revised 13 July 2013 Accepted 15 July 2013

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Relapsing polychondritis is an episodic, systemic inflammation of the cartilage with unknown autoimmune etiology. It leads to the destruction of cartilaginous structures of the ear, eye, nose, respiratory tract, joints, skin, and heart valve, and its presented symptoms are diverse. It can be improved mainly by corticosteroid or immunosuppressive agents. Recently, the use of biologic agents (TNF inhibitors, rituximab, tocilizumab et al) was reported from abroad. However, there is no reported case of relapsing polychondritis, which is treated by biologic agents in Korea. We report this first case of refractory relapsing polychondritis, which was improved with a treatment of Infliximab.

Keywords: Relapsing polychondritis, Infliximab

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Figure 1.

Photomicrograph of left auricular cartilage Biopsy. Auricular cartilage showing degeneration with vacuolization of chondrocyte, fibrosis (H&E stain, A ×100, B ×200).

Figure 2.

Photograph of right auricle in the patient. Left photo is the patient's right ear before the infliximab infusion. It shows swelling and redness of the ear, but sparing of the earlobe (A). Rigtht photo is the patient's right ear after the infliximab infusion. It shows no swelling, redness of the ear (B).

Figure 3.

Timeline of patient's medication and serum C-reactive protein (CRP). The patient received methylprednisolone 60 mg/d for 6 days when he had first flare (empty arrow). The patient received infliximab when he had second flare (filled arrow).

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