title: A Case of Relapsing Polychondritis Initiating with Unexplained Fever.
abstract: Relapsing polychondritis (RP) is a rare autoimmune disease affecting the multiple organ system. Here, we describe a case of RP initially presenting with high fever. The patient was referred to our hospital for further examination of fever of unknown origin (FUO). On admission, the patient reported dry cough in addition to fever. On physical examination, her red, swollen ears were noted, attributed on histology to inflammation with auricular perichondritis. She was diagnosed with RP and treated with oral prednisone (50 mg/day); her fever and auricular inflammation resolved. The patient no longer reported cough and body temperature returned to normal and the elevated levels of C-reactive protein (CRP) were normalized. In this case, identification of the origin of fever was a challenge because of unspecific symptoms; however, awareness of the systemic manifestations of RP may lead to the prompt diagnosis and therapeutic intervention.
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Hirayama
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Iwanaga
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Yasumori
authors.initials: Y
authors.lastname: Izumi
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoshimura
authors.affiliation: Department of Pathology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kurohama
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Yamashita
authors.affiliation: Department of Ophthalmology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Takahata
authors.affiliation: Department of Otolaryngology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Oku
authors.affiliation: Department of Pathology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Rheumatology, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.affiliation: Department of General Internal Medicine and Rheumatology, Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8562, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Migita