Rare lung & airway condition
Relapsing polychondritis and the airway
Relapsing polychondritis is a rare autoimmune attack on cartilage - ears, nose, joints - and its most dangerous target is the airway, where inflamed cartilage can soften and collapse.
Key points
The essentials at a glance.
What to look out for, how the diagnosis is confirmed, who looks after it, and the options that exist.
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01
Airway involvement affects a large minority and may cause cough, hoarseness, wheeze, stridor or recurrent infections.
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02
The classic peripheral clue: painful, red inflamed ears sparing the (cartilage-free) earlobes.
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03
Dynamic CT and bronchoscopy assess airway inflammation and collapse; PET can map active disease.
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Airway disease escalates treatment: steroids plus immunosuppressants or biologics.
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Severe collapse may need CPAP, stenting or surgery in specialist airway centres - and anaesthetics require careful planning.
Understanding it
What it is, and what happens next.
In plain English - what is going on, how specialists confirm it, and the routes to treatment in the UK.
Cartilage keeps the airway open from voice box to bronchi, and relapsing polychondritis inflames precisely that scaffold. Attacks may announce themselves elsewhere - flaming ears, a saddle-nose change, joint pains - while the airway erodes quietly; once cartilage rings soften, the trachea can collapse dynamically, turning each forceful breath or cough into an obstruction.
Any diagnosis of relapsing polychondritis warrants proactive airway assessment rather than waiting for stridor: dynamic imaging and lung function map involvement, rheumatology-led immunosuppression treats the fire, and complex airway teams manage established malacia with positive pressure, carefully chosen stents or reconstructive options.
A quiet reminder
This guide is for information, not medical advice.
Your GP or specialist knows your history and can tell you which parts apply to you. If in doubt, speak to them.
Published 2026-09-27 · Next review 2027-09-27
Frequently asked
Common questions about Relapsing polychondritis and the airway.
Quick, plain-English answers to what people ask us most.
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How does relapsing polychondritis affect the airway?
Relapsing polychondritis is a rare autoimmune attack on cartilage throughout the body, and its most dangerous target is the airway, where inflamed cartilage in the windpipe and voice box can soften and collapse, threatening breathing.
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What are the symptoms of airway involvement in relapsing polychondritis?
Symptoms include hoarseness, a persistent cough, breathlessness, wheeze, and a feeling of tightness in the throat or chest, which can progress if the airway cartilage weakens further.
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Is airway involvement in relapsing polychondritis dangerous?
Yes, it is potentially life-threatening, as significant airway cartilage collapse can cause severe breathing difficulty, making this the aspect of relapsing polychondritis that needs the most vigilant monitoring.
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How is airway involvement assessed in relapsing polychondritis?
Assessment typically includes CT imaging of the airway, lung function tests, and sometimes direct visualisation with a scope (bronchoscopy) performed carefully given the risk of triggering airway compromise.
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How is airway involvement in relapsing polychondritis treated?
Treatment centres on immunosuppressive medication to control the underlying inflammation, and in cases of significant airway narrowing or collapse, procedures such as stenting or tracheostomy may be needed to keep the airway open.
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How is relapsing polychondritis diagnosed?
Diagnosis is largely clinical, based on the pattern of cartilage inflammation affecting sites like the ears and airway, supported by imaging and sometimes biopsy, since there is no single definitive blood test.
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Relapsing polychondritis airway involvement vs ear involvement - what's the difference?
Ear involvement causes painful, red, swollen ears but is not immediately dangerous, whereas airway involvement carries a genuine risk to breathing and requires much closer, more urgent monitoring and treatment.
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When should I seek urgent care for relapsing polychondritis airway symptoms?
Seek urgent medical attention for new or worsening breathlessness, wheeze, hoarseness, or throat tightness if you have relapsing polychondritis, as airway involvement can progress and needs prompt specialist assessment.