Postpartum inflammation of the auricle as the first manifestation of relapsing polychondritis

Introduction Relapsing polychondritis (RP) is a rare multisystem disease in which autoimmunogenesis is assumed. Perichondritis of the auricle is one of the most common symptoms, but in principle other cartilage localisations as well as various organs may also be affected. Conductive hearing loss and vestibulocochlear symptoms are often associated with RP. The diagnosis of RP is clinically established. Due to the broad spectrum of manifestations, the management of RP is usually interdisciplinary. The therapy of the disease is empirical and consists of the administration of immunosuppressiv drugs, steroids, NSAIDs and biologics, depending on the severity of the symptoms.

Case report We report on two patients who showed the first manifestation of RP a few days after delivery. In both cases, the women developed bilateral auricular perichondritis, bilateral conjunctivitis, bilateral sensorineural hearing loss and bilateral tinnitus. The previous pregnancies were without complications. Under high-dose corticosteroid therapy both patients experienced a gradual resolution of symptoms, with perichondritis showing the most rapid healing tendency in each case.

Conclusions Pregnancy possibly triggers the manifestation of RP. This could be an indication of hormonal factors in the development of the disease, given that the pathogenesis of PR has not yet been conclusively clarified. RP should be considered in the differential diagnosis of pregnant women with auricular inflammation, especially if it is associated with other symptoms.

Publication History

Article published online:
12 May 2023