The association of relapsing polychondritis and spondylarthritis – three case reports

Abstract

Background. Relapsing polychondritis (RP) is characterized by recurrent episodes of progressive inflammation that lead to the destruction of cartilaginous structures. The etiopathogenesis is not fully elucidated, but it seems to be an immunemediated mechanism directed against type 2 collagen. Case reports. We present a series of 3 clinical cases, which associate RP and spondylarthritis – a woman with psoriatic arthritis (PsA) and two men with ankylosing spondylitis (AS). All cases presented with auricular chondritis, which is the emblem of RP. In the PsA case, RP presented typically, with recurrent auricular chondritis, manifested clinically with a cauliflower-like appearance of the ears. In one of the AS cases, a paradoxical immune reaction related to biological therapy was considered in the differential diagnosis of RP. In the other AS case, the patient had a single episode of chondritis, the recurrence of the disease remains to be proved. Conclusions. The diagnosis of RP is usually based on clinical evidence and the elimination of differential diagnoses, since there is no specific laboratory or imaging test. In 20-30% of cases, RP is associated with other conditions, most frequently with vasculitis, but the association of RP with spondylarthritis is rare.

Keywords

• relapsing polychondritis
• ankylosing spondylitis
• psoriatic arthritis