Relapsing Polychondritis Presenting with Severe Laryngotracheobronchial Involvement and a Posterior Laryngeal Web: A Case Report

Background Relapsing polychondritis (RP) is a rare inflammatory disorder that can cause severe laryngotracheobronchial complications. Its airway manifestations may resemble bronchial asthma, delaying recognition and appropriate management. Case presentation: A 45-year-old woman presented with a four-year history of progressive dyspnea, inspiratory stridor, wheezing, and weight loss despite repeated treatment for presumed bronchial asthma. Laryngoscopy revealed subglottic stenosis and a posterior laryngeal web requiring emergency tracheostomy and surgical excision. Subsequent computed tomography and bronchoscopy demonstrated severe tracheal narrowing, carinal distortion, complete left main bronchial obstruction, and left lung collapse. Tuberculosis and autoimmune investigations were inconclusive. Relapsing polychondritis was suspected based on the clinical and airway findings, but remained unconfirmed, and endobronchial tuberculosis could not be excluded. The patient received corticosteroids and antituberculosis treatment, followed by bronchoscopic balloon dilatation for persistent tracheal stenosis. She remained clinically stable during three years of follow-up, with minimal residual stridor; however, no follow-up imaging or bronchoscopy was performed to assess anatomical resolution. Conclusion This case illustrates the diagnostic challenges of unexplained progressive laryngotracheobronchial stenosis and highlights the importance of considering Relapsing polychondritis while acknowledging competing diagnoses. Long-term clinical stability does not necessarily indicate anatomical resolution of major airway obstruction.