A Case of Relapsing Polychondritis: Unmasking the Otitis Externa Mimic

• Published in: Curēus (Palo Alto, CA) CA), 2024-07, Vol.16 (7), p.e64070
• Main Authors: Bandari, Vandana, Aguilar, Ben Hur
• Format: Article
• Language: English
• Subjects: Age groups; Antibodies; Antigens; Carbon dioxide; Cartilage; Collagen; Disease; Ears & hearing; Hearing loss; Hemoglobin; Inflammation; Nonsteroidal anti-inflammatory drugs; Patients; Proteins; Rheumatology; Steroids
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.64070

Relapsing polychondritis (RPC) is a rare autoimmune condition that often mimics recurrent external otitis. This multisystemic disease primarily affects cartilaginous structures in the body, with the ear pinna being the most commonly impacted. RPC is associated with elevated inflammatory markers and antinuclear antibodies (ANA), and it can lead to chondral destruction. Our case is a 74-year-old Caucasian male with a history of peripheral vascular disease (PVD) who presented to the clinic with recurrent, painful swelling of the right upper ear for 14 days despite multiple antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs). He had chronic sensorineural hearing loss in the same ear. He was seen multiple times with identical symptoms in the last seven months and was diagnosed with otitis externa. He denied arthritis, fatigue, rash, abrasion, allergies, trauma, or fever. He was prescribed antimicrobials, alternating NSAIDs, and methylprednisolone with temporary relief. He is only on statins and has an unremarkable family history. He was afebrile with normal vital signs. On physical examination, he was not in acute distress and had a normal voice but had a diffusely erythematous, tender, swollen right ear pinna and external canal sparing the lobe. The rest of the physical examination was unremarkable. Laboratory results showed elevated C-reactive protein (CRP) of 100 mg/L (normal range: