Limb lymphoedema in rheumatoid arthritis.

Bamji, Andrew

doi:10.1136/ard.50.6.407

Cited by 15 publications

(12 citation statements)

References 2 publications

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“…Disease-modifying drugs were used in the treatment of lymphedema associated with rheumatoid diseases; however, they were inadequate most of the time (9,18). In some cases, intra-articular corticosteroid injections can result in the resolution of lymphedema in a short time (19,20). Grillet et al (21) found a prominent decrease in lymphedema with pulse methylprednisolone therapy in their case.…”

Section: Discussionmentioning

confidence: 97%

Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case

Gökmen¹,

Akbal²,

Savaş³

et al. 2015

Turk J Phys Med Rehab

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Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy characterized by peripheral arthritis, enthesis, spondylitis, and psoriasis. Lymphedema arises from the slowing of lymphatic flow because of inflammatory or noninflammatory diseases such as tumors, infections, bursitis, rheumatoid arthritis, and polymyalgia rheumatica. It is commonly encountered in one or more regions of distal extremities. Lymphedema is a rare complication of PsA, and it is commonly seen asymmetrically and in lower extremities. We aimed to report a case, who followed-up with diagnosis with PsA and with complaints of upper extremity swelling and bilateral upper extremity lymphedema diagnosed as a result of the review.

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Section: Discussionmentioning

confidence: 97%

Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case

Gökmen¹,

Akbal²,

Savaş³

et al. 2015

Turk J Phys Med Rehab

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“…According to our knowledge, only few patients with PsA and distal extremity swelling with pitting oedema have been reported in literature [2,[4][5][6]. In all cases, oedema predominantly aVected the upper limbs with asymmetrical pattern and its onset was not directly connected with the severity of arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Until now, few cases have been described in literature [2][3][4][5][6][7][8]. Lymphoedema occasionally occurs in the upper limbs and the legs in RA.…”

Section: Introductionmentioning

confidence: 99%

Two cases of distal extremity swelling with pitting oedema in psoriatic arthritis: the different pathological mechanisms

et al. 2009

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In psoriatic arthritis, swelling and pitting oedema may be caused by diVerent pathogenic mechanisms: on one hand, the involvement of tenosynovial structures; on the other hand, the involvement of lymphatic vessels, which may be rarely implicated by the inXammatory process. This diVerent involvement is responsible for a diVerent response to therapy and a diVerent clinical outcome. In fact, patients with inXammation of the tenosynovial structures and normal lymphatic drainage have a more favourable clinical outcome and response to pharmacologic treatment, whilst patients aVected by psoriatic arthritis with chronic lymphatic vascular damage are characterized usually by resistance of oedema to therapy. In this study, we report two cases of psoriatic arthritis with distal extremity swelling and pitting oedema. In the Wrst patient, the swelling and pitting oedema were associated with lymphatic obstruction, as detected by lymphoscintigraphy. In the second, the predominant involvement of the tenosynovial structures, as shown by magnetic resonance, with normal lymphatic Xow, may have been the cause of arthritis with oedema. These diVerent pathogenetic mechanisms were associated with diVerent response to therapy. Nevertheless, oedema was resistant to therapy in both patients probably because of other unknown factors, which inXuence therapy and clinical outcome.

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“…A small proportion of patients with rheumatoid arthritis (RA) develop peripheral oedema involving the dorsum of the hands and/or feet without any relation to general factors such as anaemia, hypoalbuminaemia or generalised fluid retention [1][2][3]. The results of previous studies have suggested that such oedema may be the consequence of venous obstruction, a generalised increase in capillary permeability or lymphatic obstruction [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…In patients from the first group an extension of the inflammatory process to the lymphatic vessels may have caused the chronic lymphangitis responsible for it. In patients from the second group a transient lymphatic obstruction caused by the extensor tendon synovitis may have been the cause of the oedema [3,[9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Distal Extremity Swelling with Pitting Oedema in Rheumatoid Arthritis

Paira¹,

Caliani²,

Luraquiz³

2001

Clin Rheumatol

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Distal extremity swelling with pitting oedema due to altered lymphatic drainage has been reported in some patients with rheumatoid arthritis (RA). The resistant-to-therapy oedema usually affected the upper limbs in an asymmetrical pattern. Until now, extensor tenosynovial involvement has not been described in RA patients suffering from distal extremity swelling with pitting oedema. Three patients are described: two of them had predominant extensor tenosynovial involvement in their hands, with impaired lymphatic drainage demonstrated by (MRI) and lymphoscintigraphy, respectively. In both cases the oedema was chronic and not responsive to treatment. One patient had extensor tenosynovial involvement without impaired lymphatic drainage. In this case, the oedema remitted completely after a few days of corticosteroid therapy. None of them showed differences in serum levels of vascular endothelial growth factor (VEGF), whether they were RA patients with no pitting oedema or healthy volunteers.

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Limb lymphoedema in rheumatoid arthritis.

Cited by 15 publications

References 2 publications

Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case

Bilateral Upper Extremity Edema in the Psoriatic Arthritis Case

Two cases of distal extremity swelling with pitting oedema in psoriatic arthritis: the different pathological mechanisms

Distal Extremity Swelling with Pitting Oedema in Rheumatoid Arthritis

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