Description
A 59-year-old man with chronic obstructive pulmonary disease (COPD) presented with dyspnoea for 3 days. Physical examination revealed diffuse rhonchi over chest, and very hard, thick, deformed auricles except for the ear lobules, which were soft (figure 1A). Patient reported remote history of episodic pain and redness of his ears and nose, which improved with over-the-counter pain medicines. A radiograph of the ears showed calcification of the auricular cartilages (figure 1B, white arrow). A complete blood count showed neutrophilic leucocytosis of 13.1x103/µL and chronic normocytic anaemia of 12.3 g/dL. Inflammatory markers including erythrocyte sedimentation rate and C reactive protein, and renal and liver function tests were normal. Prior work-up was negative for antinuclear and antineutrophil cytoplasmic antibodies. A clinical diagnosis of relapsing polychondritis (RP) was made based on the reported history and the Michet criteria.1 Review of a prior lung function test ruled out any...
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