Case of relapsing polychondritis with different ocular inflammations

AbstractPurpose We present a case of relapsing polychondritis with orbital cellulitis.Methods A 71‐year‐old man had age‐related macular degeneration and had been treated by an intravitreal injection of anti‐VEGF in another hospital. Three months later, he noted that he was deaf in both ears. At the same time, he developed scleritis in the right which was improved by a topical steroids. At the first visit to our hospital, he had a reddish swelling in the left eyelid with pain. There was also a reddish swelling of the right auricula. CT examinations showed maxillary sinusitis, and he was diagnosed with left orbital cellulitis. He was treated with intravenous antibiotics, and the left orbital cellulitis rapidly improved but he developed right scleritis and left gonitis. Blood tests showed an elevation of ESR and CRP, and positive antinuclear antibody. MRI showed bilateral posterior scleritis and right auricular perichondritis.Results Because he had auricular perichondritis and cochleovestibular disorders, auricular biopsy was performed, and an infiltration of lymphocytes into the periauricular tissue was found histologically. Taken together, he was diagnosed with relapsing polychondritis. Oral predonisolone treatment was performed by a consulting rheumatologist, and both ocular and auricular inflammations improved. He continues with the oral predonisolone.Conclusion Although ocular complications of relapsing polychondritis are rare, polychondritis is a life‐threatening disease. Thus, ophthalmologists should consider relapsing polychondritis in patients with both ocular and auricular inflammation.