INTRODUCTION: Relapsing polychondritis (RP) is a rare disease presenting most commonly as inflammation of the cartilage of the ears and nose. The diagnosis is made essentially by clinical means. Cartilage involvement may cause collapse and obstruction of the airways. Respiratory complications have accounted for most deaths due to RP. The frequent presence of antibodies against type II collagen gives credence to an autoimmune etiology. CASE REPORT: We report the case of a 22-year-old woman with RP that had started 10 years ago with an attack of auricular chondritis after she got her ear pierced. She had been hospitalized a year ago for severe dyspnea, for which she underwent tracheostomy. Physical examination showed deformity and hyperemia of the ears and the saddle of the nose. Videolaryngoscopy revealed fixed arytenoid cartilages and subglottic stenosis; these findings were confirmed on CT scanning. The disease remained out of control despite the regular use of prednisone and methotrexate. CONCLUSION: Respiratory complications are responsible for the significant morbidity and mortality associated with RP. The results of systemic treatment have always been disappointing, although earlier diagnosis could lead to better outcomes. Nevertheless, many patients experience symptom progression and eventually require tracheostomy, which may not be fully palliative because of softening and frequent obstruction of distal airways beyond the tracheostomy site.
