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Relapsing polychondritis presented as inner ear involvement

Published online by Cambridge University Press:  29 June 2007

Yasuyuki Kimura ,
Hiroko Miwa ,
Mitsuru Furukawa  and
Yuji Mizukami
Yasuyuki Kimura*
Affiliation:
Department of Otolaryngology, Kanazawa University School of Medicine, Kanazawa, Japan.
Hiroko Miwa
Affiliation:
Department of Otolaryngology, Kanazawa University School of Medicine, Kanazawa, Japan.
Mitsuru Furukawa
Affiliation:
Department of Otolaryngology, Kanazawa University School of Medicine, Kanazawa, Japan.
Yuji Mizukami
Affiliation:
Department of Otolaryngology, Kanazawa University School of Medicine, Kanazawa, Japan.
*
Address for correspondence: Yasuyuki Kimura, M.D., Department of Otolaryngology, Kanazawa University, School of Medicine, Takara-machi 13-1, Kanazawa 920, Japan. Fax 0762-34-4265
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Abstract

We report a rare case of relapsing polychondritis with an initial symptom of inner ear involvement. This 53-year-old Japanese man experienced a hearing difficulty, tinnitus in both ears, and dizziness of sudden onset, but lacked auricular chondritis at that time, which is the most frequent finding in relapsing polychondritis. Thus it was difficult to reach a correct diagnosis. Steroid therapy, with oral prednisolone 15 mg daily, was effective. Almost two months after we began the steroid therapy, the patient complained of losing interest in his work and reported a hallucination vision on the TV screen, so the dose of prednisolone was decreased to 10 mg. The hallucinations then disappeared, but the serum level of C-reactive protein increased highly. To reduce the dose of prednisolone, we tried low-dose oral methotrexate. However, we had to discontinue it when the patient experienced severe vomiting and diarrhoea. As adjuvant therapy, we then administered Sho-saiko-to, Chinese herbal medicines with few side effects. Symptoms and laboratory abnormalities then improved markedly.

Keywords

Hearing loss, sensorineuralTinnitusEar cartilages, infectionSteroidsMethotrexate
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 2 , February 1996 , pp. 154 - 157
Copyright
Copyright © JLO (1984) Limited 1996

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