A 38-year-old male complained of intermittent pain and mild swelling in ankle and foot joints for two years. He was under treatment by a homeopathic doctor without any significant relief. His joint pain was associated with pain in the rib cage and sometimes with a change of voice and redness of the eyes. He used to feel feverish during these arthritic episodes and was generally unwell. He also developed loss of appetite and nutritional anemia.
Because of no response to homeopathic drugs, he switched to Ayurveda therapy. The Ayurveda physician prescribed him purging, which was followed by severe abdominal pain, diarrhea, and dehydration. He was hospitalized for the same, where his condition stabilized. He developed pain and mild swelling in some of his joints and pain in the left lower ribs. This pain was followed by painful, pink, tender, and warm swelling of the pinna of his left ear – a classic finding in Relapsing Polychondritis.
Relapsing Polychondritis is a multisystem autoimmune disease due to swelling of the cartilage tissue. Cartilage is a firm (softer than bone) and flexible structure that is found in the ear (external as well as internal), nose, glottis (the phonating organ in the throat), windpipe (trachea), rib cage, joints, and intervertebral discs. Relapsing Polychondritis can be primary or be associated (30% cases) with various autoimmune and other diseases. Recurrent swelling of the ear, nose, and other organs leads to deformities (cauliflower ear, saddle nose). Obstruction of windpipe, deafness, and redness of the eye with diminution of vision are dreaded complications occurring in about 50% of patients over the course of this disease. Defects of heart valves (aortic), swelling of blood vessels, involvement of the nervous system and kidneys can also occur in Relapsing Polychondritis. The prognosis of patients with Relapsing Polychondritis has significantly improved due to better management of drugs and surgery in selected patients.
