Diagnosis is dependent upon biopsy, which shows inflammatory subepithelial bullae surrounded by a mixed cellular inflammatory infiltrate. Intralesional steroids are ineffective, and stenoses require surgical correction. Relapsing Polychondritis Relapsing polychondritis is a rare idiopathic, generally progressive, autoimmune disease that causes inflammation of cartilage. Relapsing polychondritis occurs in all age groups, having a bell-shaped distribution and a peak incidence in the fourth decade. This disease is characterized by episodes of inflammation with subsequent destruction of the cartilage of the ears, nose, and larynx.
Arthritis involving the large joints is also common.
Laryngeal involvement is manifested by hoarseness, dyspnea, stridor, cough, and, sometimes, pain and hemoptysis. On examination of the larynx, severe glottic and subglottic edema and inflammation are seen. No laboratory test is diagnostic, although patients with active disease usually have an elevated erythrocyte sedimentation rate, and most patients with this disorder also have autoantibodies to type II collagen. Relapsing polychondritis is therefore a clinical diagnosis that is confirmed by cartilage biopsy. Initially, most patients present with bilateral involvement of the ear cartilage.