Treatment of Relapsing Polychondritis with Laryngeal or Tracheobronchial Chondritis (Without Acute Respiratory Failure)

Clinical Scenario

This protocol addresses patients with relapsing polychondritis who present with laryngeal chondritis or tracheobronchial chondritis, in the absence of acute respiratory failure. Airway involvement at these sites represents a clinically significant manifestation requiring prompt, coordinated management.

Management Considerations

Given the anatomical sites involved — the larynx and tracheobronchial tree — care should be coordinated in close collaboration with a pulmonologist and/or ENT physician alongside the treating rheumatologist.

Treatment Approach (Partial)

Management centres on systemic corticosteroid therapy, with the specific agent, route of administration, and intensity calibrated to disease severity and clinical course. An inhaled corticosteroid component may also be incorporated.

Full regimen detail — including sequencing, tapering schedule, and dosing thresholds — is available in the complete protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.revmed.2023.05.005

The management of patients with laryngeal or tracheobronchial relapsing polychondritis should be done in close collaboration with the pulmonologist and/or ENT physician.
Initial corticosteroid therapy is 0.5 to 1 mg/kg/day of prednisone-equivalent, not exceeding 60 to 70 mg/day for at least 3 weeks depending on severity and clinical course, followed by a tapering dose with the aim of reaching a dosage of less than or equal to 15 mg/day at 3 months and less than or equal to 10 mg/day at 6 months.
Infusions of methylprednisolone (250–1000 mg/d for 1–3 days) may be used depending on severity.
Inhaled corticosteroid therapy may be used in combination.

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