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Image Gallery: Relapsing polychondritis associated with monoclonal gammopathy

DEAR EDITOR, A 76-year-old man, previously diagnosed as having monoclonal gammopathy of undetermined significance (MGUS), presented with hoarse voice, unexplained fever and (a) recurrent episodes of chondritis of the left pinna (arrows). (b) Computed tomography demonstrated involvement of cartilage of the respiratory tract (arrow). The histological findings were compatible with relapsing polychondritis (RP). RP is a recurring, progressive, autoimmune, inflammatory disorder that affects proteoglycan-rich tissues. It has been described as a paraneoplastic phenomenon. The patient improved clinically after treatment with methylprednisolone 0 2–0 3 mg kg 1 daily for 4 weeks and topical glucocorticoids. We referred the patient to a haematologist for treatment for MGUS, which was responsible for the RP.