Relapsing polychondritis: A Patient Guide

Relapsing polychondritis (RP) is a rare and complex autoimmune condition characterized by recurrent inflammation of the body’s cartilage. In a healthy body, cartilage provides essential structure and flexibility; however, in RP, the immune system mistakenly identifies this tissue as a foreign threat and launches an inflammatory attack. While this often first appears as painful swelling or redness in the “visible” cartilage of the ears and nose, RP is a systemic disease that can involve any tissue where specific types of collagen and proteins are present ^[1].

This guide is an educational resource. RP is rare, and much of the medical evidence is observational. Emergency symptoms always override routine plans, and you should never change immunosuppressive medications without your clinician.

The true challenge of living with RP lies in its ability to affect vital internal structures that you cannot see or feel. Beyond the ears and nose, the disease can target the cartilage holding your windpipe open, the valves within your heart, the aorta, and the delicate tissues of your eyes. Because damage to the airway or the aorta can progress “silently”—meaning it may cause no obvious symptoms until the damage is significant—specialist-guided baseline screening and individualized ongoing monitoring are important considerations for safe management ^[2][3].

Treatment for RP is highly individualized, as no two patients experience the same disease course. The primary goal of your medical team will be to rapidly suppress active inflammation to prevent permanent structural damage. While corticosteroids are often used to achieve this quickly, the long-term strategy focuses on introducing “steroid-sparing” immunosuppressants and biologics. These medications are used to keep the disease in remission while minimizing the side effects associated with long-term steroid use ^[4][5].

Recent scientific breakthroughs have further refined our understanding of this condition, particularly through the discovery of VEXAS syndrome. This condition, caused by an acquired genetic mutation, acts as a mimic or overlap syndrome. While not everyone with RP needs testing, evaluating for VEXAS is an important consideration for a specific subset of patients (typically older men) who experience severe symptoms that resist standard treatments. Ultimately, while an RP diagnosis brings uncertainty, a proactive approach centered on expert coordination and individualized monitoring provides the best path toward protecting your health and maintaining your quality of life ^[6][7].