Clinical Characteristics of Patients with Remitting Seronegative Symmetrical Synovitis with Pitting Edema Compared to Patients with Pure Polymyalgia Rheumatica

Kimura, Makiko; Tokuda, Yasuharu; Oshiawa, Hideto; Yoshida, Kazuki; Utsunomiya, Masako; Kobayashi, Tatsuo; Deshpande, Gautam A.; Matsui, Kazuo; Kishimoto, Mitsumasa

doi:10.3899/jrheum.110558

Cited by 44 publications

(35 citation statements)

References 29 publications

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“…[3,4] S›kl›kla geriatrik popülas-yonda ve erkeklerde kad›nlardan daha s›k olarak görül-mektedir. [5,6] Etiyolojisi aç›k olmamakla birlikte az say›da olgu ile yap›lan çal›flmalarda interlökin (IL)-6 düzeylerinin yük-sek bulunmas› inflamasyonun rolünü ortaya koymaktad›r. [7] Ayr›ca potent bir vazodilatatör olan ve damar geçir-genli¤ini artt›ran 'vaskular endotelyal büyüme faktörü' (VEGF) düzeyleri, RS3PE'li hastalarda kontrol grubuna göre anlaml› düzeyde yüksek bulunmufltur.…”

Section: Tart›flmaunclassified

“…Çeflitli serilerde ortalama malignite oran› %7-31 aral›¤›nda bildirilmifltir. [5] Bu veri RS3PE'li hastalardaki malignite insidans›n›n normal populasyona oranla önemli oranda yüksek oldu¤unu desteklemektedir. Ancak RS3PE'li hastalarla ilgili genifl olgu serileri olmad›¤›ndan bu hastalardaki gerçek malignite insidans› bilinmemektedir.…”

Section: Tart›flmaunclassified

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A diagnosis that can be easily neglected: remitting seronegative symmetrical synovitis with pitting edema

Turan¹,

Emmüngil²

2017

RAED Derg

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Section: Tart›flmaunclassified

A diagnosis that can be easily neglected: remitting seronegative symmetrical synovitis with pitting edema

Turan¹,

Emmüngil²

2017

RAED Derg

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“…2,3,6,9,10 A study from Kimura et al in 2012 revealed that all studied patients with RS3PE met PMR criteria, an unexpected finding. 10 PMR is characterized by inflammatory pain and stiffness of the shoulder and pelvic girdles, with biochemical evidence of inflammation.…”

Section: Introductionmentioning

confidence: 99%

“…The relatively acute onset of symmetrical inflammation of joints and carpal tunnel syndrome are overlapping features. 10 However, RS3PE syndrome is more common in men, involving the wrist, carpus, and flexor digitorum tendons disproportionately, and is associated with marked pitting edema of the dorsum of the hand. In contrast, PMR is more common in women, predominantly involving the shoulders and hips.…”

Section: Introductionmentioning

confidence: 99%

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An elderly-onset rheumatic syndrome: is it RS3PE?

Oliveira

Ferreira

et al. 2017

Ital J Med

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A 75-year-old male, with a past medical history of systemic hypertension, dyslipidemia and benign prostatic hyperplasia, was referred to the Orthopedics Department with major complaints of pain and stiffness of the shoulder girdle, as well as swelling and pain of all metacarpophalangeal joints (MCP), fourth and fifth right proximal interphalangeal joints and both wrists, for at least the previous five weeks. The onset was acute and the pain was moderate to severe in intensity, with no irradiation, but there was morning stiffness lasting for less than half an hour. The patient denied any history of previous joint, bone or back pain, fever, trauma, rash or pruritus. He was diagnosed with carpal tunnel syndrome, with a com- An elderly-onset rheumatic syndrome: is it RS3PE?Marta Oliveira, Filipa Ferreira, Erica Ferreira, Rosa Jorge Internal Medicine Department, Centro Hospitalar Baixo Vouga, E.P.E. Aveiro, Portugal ABSTRACTIt is presented a case of a 75-year-old Caucasian male patient who was admitted to hospital with a history of painful swollen hands and feet, associated with worsening mobility. Examination revealed bilateral pitting edema of dorsum of hands and feet. Initial blood test showed 10.7 g/L hemoglobin with normochromic and normocytic anemia, raised inflammatory markers (erythrocyte sedimentation rate 60 mm, C-reactive protein 16.73 mg/dL) and normal white blood cells count. Autoantibody screen and rheumatoid factor were negative, with positive HLA-B27. Radiological findings of hands and feet did not show any erosions. The patient was also screened and investigated for associated malignancies; the tumor markers and the computed tomography thorax/abdomen were reported as normal. The patient responded extremely well to low dose prednisolone at 20 mg daily dosage. Further follow up 5 weeks later on tapering dose of prednisolone showed complete resolution of signs and symptoms without any further flare-ups. Remitting seronegative symmetrical synovitis with pitting edema is a definite syndrome, a rare subset of polyarthritis with favorable outcome and has a good prognosis in older patients. This case illustrates the interesting diagnosis exercise that is needed, once the multiple conditions that may be related with the disease support that this is a syndrome with potentially heterogeneous etiologies. Looking for underlying malignancy is recommended.

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2015 Recommendations for the Management of Polymyalgia Rheumatica: A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative

Dejaco¹,

Singh

Perel

et al. 2015

Arthritis & Rheumatology

196

136

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Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR

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Clinical Characteristics of Patients with Remitting Seronegative Symmetrical Synovitis with Pitting Edema Compared to Patients with Pure Polymyalgia Rheumatica

Cited by 44 publications

References 29 publications

A diagnosis that can be easily neglected: remitting seronegative symmetrical synovitis with pitting edema

A diagnosis that can be easily neglected: remitting seronegative symmetrical synovitis with pitting edema

An elderly-onset rheumatic syndrome: is it RS3PE?

2015 Recommendations for the Management of Polymyalgia Rheumatica: A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative

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