Remitting Seronegative Symmetrical Synovitis with Pitting Oedema: A Study of 12 Cases

Paira, Sergio; Graf, César; Roverano, Susana; Rossini, Julia Siano

doi:10.1007/pl00011218

Cited by 63 publications

(36 citation statements)

References 9 publications

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“…Patients have been found to respond well to low dose corticosteroids and to remain in remission (Paira et al 2002). Previous reports indicated that RS3PE syndrome could be a paraneoplastic syndrome, including of hematological disorders (Goldenberg et al 1998;Cantini et al 1999;CobetaGarcia et al 1999).…”

Section: Introductionmentioning

confidence: 99%

Myelodysplastic Syndrome Precedes the Onset of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome

Matsunaga

Izumi

Iwanaga

et al. 2015

Tohoku J. Exp. Med.

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Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is characterized by symmetrical synovitis predominantly involving the wrists, and is associated with marked pitting edema of the dorsum of the hands. Although the etiology of RS3PE syndrome is still unknown, several putative associations with malignancies and hematological disorders have been reported. Myelodysplastic syndrome (MDS) is characterized by infective hematopoiesis with possible transformation to leukemia; however, an association between RS3PE syndrome and MDS has been rarely reported. Here, we describe a 67-year-old man with MDS with refractory anemia who developed RS3PE syndrome 3 months after the diagnosis of MDS. The patient presented with polyarthritis with pitting edema at the dorsum of the hands, the elevated serum levels of C-reactive protein and a proinflammatory cytokine, interleukin-6, and the elevated plasma levels of vascular endothelial growth factor (VEGF). VEGF has been shown to be involved in the pathogenesis of RS3PE syndrome. Treatment with low doses of corticosteroids resulted in the regression of polyarthritis and pitting edema of the dorsum of the hands, as well as a reduction in the elevated levels of plasma VEGF. Partial resolution of refractory anemia was also observed with steroid therapy. In summary, RS3PE syndrome developed shortly after MDS was identified in this patient. The sequence of clinical events suggests that MDS-mediated immunological abnormalities including inflammatory cytokine induction may be responsible for the association between MDS and RS3PE syndrome. Patients with RS3PE syndrome should be screened for hematological disorders that promote proinflammatory mediators.

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Section: Introductionmentioning

confidence: 99%

Myelodysplastic Syndrome Precedes the Onset of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome

Matsunaga

Izumi

Iwanaga

et al. 2015

Tohoku J. Exp. Med.

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“…Con el tratamiento corticoideo (prednisona dosis 10-20 mg/día) a dosis bajas remite de forma completa en pocos días (11). En este caso se inició tratamiento con prednisona 20 mg cada 24 horas, observándose resolución total del edema de manos y pies a los 5 días de iniciar el tratamiento.…”

Section: Discussionunclassified

RS3PE asociado a tuberculosis

Nicolás-Sánchez

Sacanell

Oromí³

et al. 2007

An. Med. Interna (Madrid)

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INTRODUCCIÓNEl síndrome RS3PE (remitting seronegative symmetrical synovitis with pitting edema) descrito por McCarty en 1985 (1), se caracteriza por la aparición de una poliartritis simétrica bilateral seronegativa asociada a edema con fóvea en el dorso de las manos. También se conoce como polisinovitis aguda edematosa del anciano, su etiología es desconocida y tiene buen pronóstico. Su presencia también se ha relacionado con enfermedades infecciosas (1-6), sistémicas, autoinmunitarias, tumores sólidos, y neoplasias hematológicas (7-9). Su asociación a tuberculosis no se había descrito previamente.CASO APORTADO Paciente varón de 89 años sin antecedentes patológicos de interés que consultó por anorexia de mes y medio de evolución acompañada de edema en manos y pies. Refería algún episodio de rectorragia. La exploración física solo reveló el edema con fóvea limitado a articulaciones metacarpofalángicas y metatarso falángicas (Fig. 1). Con el diagnóstico de sospecha de RS3PE se inició terapia con prednisona 20 mg/24 horas, desapareciendo el edema completamente a los 5 días de tratamiento (Fig. 2). Dado que este que este síndrome puede aparecer asociado a otras patologías se realizó el estudio del paciente.En las pruebas complementarias la hemoglobina era de Hb 10,3 g/dL, con VCM 94,5 fl. La bioquímica la glucosa, urea, creatinina, ácido úrico, calcio total, fosfato, colesterol, colesterol-HDL, colesterol-LDL, proteínas totales, GPT, LDH, GGT, Na, K eran normales. Cobalaminas y folatos normales. Beta-2-microglobulina normal. En el proteinograma apareció una banda monoclonal a IgA lambda. La proteína C reactiva y la VSG eran normales. La interleucina 6 fue normal. Serología de VIH negativa. El factor reumatoide, los anticuerpos antinucleares y los anticuerpos anticitoplasma neutrófilo fueron negativos. El PSA fue normal. El fenotipo HLA-B27 fue positivo. La proteinuria de Bence-Jones fue negativa. La colonoscopia fue normal. Las radiografías de manos y pies no mostraban lesiones erosivas. En la TAC torácica en el segmento posterior del LSD se apreciaba un infiltrado pulmonar que adoptaba una morfología ramificada (tree inbud) y nodular; en el LM también se observaba un infiltrado de morfología ramificada, nodular y una condensación subsegmentaria con broncograma aéreo; tractos pleuroparenquimatosos biapicales bronquiectasias cilíndricas de pared fina en LII y con [0212-7199 (2007) RESUMENEl síndrome de sinovitis simétrica seronegativa remitente del anciano con edema y fóvea (remitting seronegative symmetrical synovitis with pitting edema) (RS3PE), se caracteriza por la aparición de una poliartritis simétrica bilateral seronegativa asociada a edema con fóvea en el dorso de las manos, y factor reumatoide negativo. Su asociación a tuberculosis no se había descrito previamente. Se presenta el caso de un paciente de 89 años que consultó por anorexia de mes y medio de evolución acompañada de edema en manos y pies, con factor reumatoide negativo. Presentaba un infiltrado pulmonar, cuyo estudio microbiológico reveló la ...

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“…But in a newer report, malignancy rate based upon the data of different studies on RS3PE patients has been estimated to be 31% 12 . Cases of RS3PE syndrome with underlying malignancy generally have systematic manifestations such as fever, anorexia and weight loss, as well as poor response to corticosteroids 31,32 . Accordingly, patients with diagnosis of RS3PE without malignancy must be followed for hematological or solid malignancies which can be diagnosed during follow-up 4,33 .…”

Section: Associated Conditionsmentioning

confidence: 99%

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome

Gökçen¹,

Kozanoğlu²

2017

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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AbstractÖz Remitting seronegative symmetrical synovitis with pitting edema is a rare rheumatological disorder that presents with symmetrical hand and/or foot edema resembling rheumatoid arthritis. It is generally seen in male patients in older age, but atypical cases in different age groups have been documented. Although no clear mechanism has been described, certain genetic and environmental factors have been suggested for etiopathogenesis. Medical treatment is mainly focused on glucocorticoid therapy. This article aims to discuss the Remitting seronegative symmetrical synovitis with pitting edema syndrome and to review the current literature.Tekrarlayıcı seronegatif pitting ödemli simetrik sinovit sendromu, romatoid artriti andıran simetrik el ve/veya ayak ödemi ile prezente olan nadir görülen bir hastalıktır. Genellikle ileri yaş erkek hastalarda görülür fakat farklı yaş gruplarında görülen atipik vakalar da bulunmaktadır. Net bir mekanizma tanımlanmamış olmasına rağmen, etiyopatogenezde belli genetik ve çevresel faktörler öne sürülmektedir. Tedavi, esasen glukokortikoid tedavisi üzerine odaklanmaktadır. Bu derlemede Tekrarlayıcı seronegatif pitting ödemli simetrik sinovit sendromunun tartışılması ve literatürün gözden geçirilmesi amaçlanmıştır.

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Remitting Seronegative Symmetrical Synovitis with Pitting Oedema: A Study of 12 Cases

Cited by 63 publications

References 9 publications

Myelodysplastic Syndrome Precedes the Onset of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome

Myelodysplastic Syndrome Precedes the Onset of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome

RS3PE asociado a tuberculosis

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome

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