Rheumatology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China.
Curtin Medical School, Curtin University Bentley Campus, Perth, Western Australia, Australia.
BMJ Case Rep. 2021 Feb 4;14(2):e238646. doi: 10.1136/bcr-2020-238646.
A 54-year-old Chinese woman presented with a 3-month history of sore throat and dry cough, which was treated as chronic pharyngitis with minimal improvement. One month ago, she presented with painful right ear swelling without signs or symptoms of otitis media or otitis externa. She was treated with antibiotics and antiviral drugs without any improvement. Two weeks prior to her presentation to hospital, she developed bilateral costal margin pain with raised C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), mild chronic pharyngitis and painful right ear swelling. All other investigations including bloods and imaging were non-specific. Her painful right auricle swelling prompted the diagnosis of relapsing polychondritis (RP), which was supported by clinical improvement with high-dose corticosteroids. RP is a clinical diagnosis with non-specific inflammation of affected cartilage. It is a diagnosis of exclusion and early diagnosis can be made by the most common presenting feature of auricular chondritis.
一位 54 岁的中国女性，因咽痛和干咳 3 个月就诊，被诊断为慢性咽炎，给予对症治疗后稍有改善。1 个月前，她出现右侧耳部肿痛，无中耳炎或外耳道炎的体征或症状。她曾接受抗生素和抗病毒药物治疗，但无任何改善。在她来医院就诊前两周，她出现双侧肋缘疼痛，伴有 C 反应蛋白（CRP）和红细胞沉降率（ESR）升高，同时伴有轻度慢性咽炎和右侧耳部肿痛。其他所有检查（包括血液检查和影像学检查）均无特异性。她的右侧耳廓肿痛提示复发性多软骨炎（RP）的诊断，大剂量皮质类固醇治疗后临床症状改善支持该诊断。RP 的诊断主要依靠临床表现，软骨炎症无特异性。这是一种排他性诊断，早期诊断可以根据最常见的耳廓软骨炎表现做出。
