Relapsing Polychondritis Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom

Ocular History  36 year old male  recurrent episodes of pain, redness in both eyes  since one year

General History  hearing impairment  external ear pain  since one year

First Presentation  VA: OU – 6/6  scleritis – OD  no AC cells, no flare  posterior segment – normal, no posterior scleritis

First Presentation 67, male, Asian- Bangladeshi 67, male, Asian- Bangladeshi No letters found, scleritis? No letters found, scleritis?  presence of diffuse non necrotising scleritis.  presence of mildly inflamed external ear (right side)

First Presentation - Investigations systemic history and systemic evaluation by internist systemic history and systemic evaluation by internist no respiratory or cardiac abnormalities no respiratory or cardiac abnormalities chest X Ray: normal chest X Ray: normal ESR and CRP – raised ESR and CRP – raised rest all blood investigations including RA factor: normal rest all blood investigations including RA factor: normal

Diagnosis  Relapsing polychondritis  based on:  clinical findings  typically: ear swelling, scleritis, arthritis

Treatment  Oral corticosteroids in tapering dose:  Starting with 60 mg/day  Reducing for 10 mg/week until 20 mg  Then slowly reduced  Stop after 18 weeks  Patient improved significantly

Follow up – After 18 Months no relapses no relapses