A Case of Relapsing Polychondritis diagnosed by Biopsy of Thyroid Cartilage

Relapsing polychondritis is a rare autoimmune disease characterized by recurrent inflammation and destruction of cartilage throughout the body. Prior to a definitive diagnosis, our patient suffered from a sore throat, hoarseness and persistent cough over a period of 1 month. Bone scintigraphy showed high integration of costochondral regions and thyroid cartilage. CT (computed tomography) demonstrated a hypodense area surrounded by enhancement around the thyroid cartilage. Due to respiratory dysfunction associated with general anesthesia, a diagnostic biopsy was delayed for 2 weeks. Therefore, the patient was referred to Otolaryngology Head and Neck Surgery and underwent biopsy of the thyroid cartilage under local anesthesia. The thyroid cartilage was inflamed and surrounded with aseptic abscesses. The patient was diagnosed as having relapsing polychondritis. The patient was administered a course of oral steroids. Most of the general symptoms including high fever and dysphasia disappeared. The early diagnosis based on the thyroid cartilage biopsy under local anesthesia enabled prevention of significant airway obstruction that would otherwise have been caused by thyroid cartilage inflammation. This is the first reported case of relapsing polychondritis diagnosed by biopsy of the thyroid cartilage.