Palindromic Rheumatism: An Unusual Cause of Chronic Intermittent Arthritis

Thapa, Sudeep Dhoj; Meysami, Alireza

doi:10.1016/j.amjmed.2015.07.012

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…Treating him with MTX 10 mg/wk led to stopping attacks and normalizing ESR and CRP 22 . Thapa et al reported controlling arthritis attacks with MTX and prednisolone in a 53‐year‐old man with PR 23 . Padhan et al reported results of treatment with MTX in 15 patients with RF and or ACPA positive PR who had active disease despite treatment with HCQ 5 mg/kg/d ± low‐dose prednisolone for at least 6 months 7 .…”

Section: Discussionmentioning

confidence: 99%

“…22 Thapa et al reported controlling arthritis attacks with MTX and prednisolone in a 53-year-old man with PR. 23 Padhan et al reported results of treatment with MTX in 15 patients with RF and or ACPA positive PR who had active disease despite treatment with HCQ 5 mg/kg/d ± low-dose prednisolone for at least 6 months. 7 They defined active disease as ≥2 attacks of arthritis per month.…”

Section: Ta B L E 2 Outcomes Of Treatment With Mtx In 59 Patients Wit...mentioning

confidence: 99%

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Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

et al. 2022

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Objective Palindromic rheumatism (PR) is characterized by self‐resolving and short duration attacks of arthritis/periarthritis. The present study was performed to report the results of PR treatment with methotrexate (MTX). Methods We reviewed the charts of 152 patients with diagnosis of PR. Inclusion criteria were diagnosis of PR according to the criteria of Weismann, age ≥16, active disease and treatment with MTX for at least 6 months. Disease outcome was assessed by reaching remission and prevention of disease evolution to chronic arthritis. Remission was defined as stopping the attacks for 12 weeks and prednisolone dose ≤5 mg/d. MTX treatment failure was defined as failure to achieve remission, the need to add other disease‐modifying antirheumatic drugs and disease progression to chronic arthritis. Results Fifty‐nine patients were included in the study. Median duration of follow‐up was 43 months. Attacks were controlled in 89.8% of patients. In 80% of the patients remission occurred during 12 months after starting treatment with MTX. Treatment failed in 20.3% of patients. Wrist joint involvement and positive rheumatoid factor (RF) were significantly more common in the MTX treatment‐failed group. In RF positive patients evolution to rheumatoid arthritis was more common than in RF negative patients. No significant differences were observed in remission rate and evolution to rheumatoid arthritis in anticitrullinated C peptide positive and negative patients. Conclusions The present study, demonstrated the efficacy of MTX in controlling PR in seropositive and seronegative patients over a median of 43 months of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 2 Outcomes Of Treatment With Mtx In 59 Patients Wit...mentioning

confidence: 99%

Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

et al. 2022

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“…Shinjo et al reported a patient with PR associated with hypertrophic osteoarthropathy who had a good response to methotrexate (MTX) 43 . Thapa et al reported a successful treatment of a 53‐year‐old man with MTX 44 . In a recent prospective study, 15 patients with seropositive PR with active disease despite treatment with HCQ were treated with combination of MTX 7.5‐25 mg per week and HCQ 45 .…”

Section: Resultsmentioning

confidence: 99%

“…43 Thapa et al reported a successful treatment of a 53-year-old man with MTX. 44 In a recent prospective study, 15 patients with seropositive PR with active disease despite treatment with HCQ were treated with combination of MTX 7.5-25 mg per week and HCQ. 45 The defined active disease as ≥2 attacks per month after 6 months of treatment.…”

Section: Methotrexatementioning

confidence: 99%

Treatment of palindromic rheumatism: A systematic review

et al. 2021

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Palindromic rheumatism (PR) is an intermittent disease characterised by recurrent and self-resolving attacks of inflammation in the articular and peri-articular tissues. Attacks usually are monoarticular and last from a few hours to a few days. 1 During attacks, patients are asymptomatic. 1 Attacks mostly involve the knees, wrists, metacarpophalangeal joints and proximal interphalangeal (PIP) joints. 1 Finding autoantibodies associated with rheumatoid arthritis (RA) in a large percentage of patients with PR is an interesting feature of this disease. 2,3 In most reports, the frequency of positive rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP) in patients with PR is similar to RA. 2,3 Two recent studies reported two other autoantibodies, antimutated citrullinated vimentin (anti-MCV) in 70% and anticarbamylated protein/peptide antibodies (anti-CarP) in 24% of PR patients. 4,5 PR is an important disease despite the little attention paid to it. Firstly, PR is a relatively common disease. Pasero and Barbieri reported that the frequency of PR was 5% of RA. 6 Powel et al reported more prevalence of PR and concluded that for each of the

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