Synovitis with pitting edema as the presenting manifestation of systemic lupus erythematosus

Hegazi, Mohamed Osama; Saleh, Faisal; Rashidi, Abdulrahman Al; Yaktien, MM

doi:10.1177/0961203314533601

Cited by 10 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These rheumatic conditions are systemic lupus erythematosus [40], gout [41], Sjogren's syndrome [42], polyarteritis nodosa [43], ankylosing spondylitis [44], sarcoidosis [45], amyloidosis [46], relapsing polychondritis [27], and bronchiolitis obliterans organizing pneumonia [47]. In addition, other medical conditions or drugs associated with RS3PE include diabetes mellitus [48], dipeptidyl peptidase-4 inhibitors [49], rifampin [50], and insulin therapy [51].…”

Section: Rs3pe Is Associated With Diseases and Medications Other Thanmentioning

confidence: 99%

RS3PE: Clinical and Research Development

Altman

Yao

2015

Curr Rheumatol Rep

View full text Add to dashboard Cite

Remitting seronegative symmetrical synovitis with pitting edema or RS3PE is a rare elderly-onset rheumatic syndrome. Although there are overlapping clinical manifestations between RS3PE, elderly-onset rheumatoid arthritis, and polymyalgia rheumatica, RS3PE has distinct characteristics. RS3PE can be associated with neoplasia and various rheumatic conditions, suggesting that it may be heterogeneous, and is considered as a paraneoplastic rheumatic disease. The pathogenesis of RS3PE may involve vascular endothelial growth factor and infection in RS3PE based upon limited data. Patients with RS3PE without concomitant malignancy respond well to small doses of glucocorticoids and carry good prognosis.

show abstract

Section: Rs3pe Is Associated With Diseases and Medications Other Thanmentioning

confidence: 99%

RS3PE: Clinical and Research Development

Altman

Yao

2015

Curr Rheumatol Rep

View full text Add to dashboard Cite

show abstract

“…There were no manifestations to support the presence of other conditions such as systemic lupus erythematosus, vasculitis, or PMR. 14,15,19,20 As noted above, RS3PE can present as paraneoplastic syndrome. The history, clinical examinations, and ultrasound scan of the abdomen and pelvis, blood picture, and chest radiograph were normal in this case.…”

Section: Discussionmentioning

confidence: 94%

“…There were no manifestations to support the presence of other conditions such as systemic lupus erythematosus, vasculitis, or PMR. 14,15,19,20…”

Section: Discussionmentioning

confidence: 99%

An unusual case of remitting seronegative symmetrical synovitis with pitting edema: Case report and literature review

Joseph

Kumanan

Aravinthan

et al. 2020

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Remitting seronegative symmetrical synovitis with pitting edema is a rare but well-recognized clinical entity that is easily overlooked due to lack of clinical vigilance. It is classically described as an acute onset of symmetrical tenosynovitis of both upper and lower extremities with pitting edema, mostly noted in elderly population. Young patients with other rheumatological diseases and unilateral involvement had also been reported, but symmetrical remitting seronegative symmetrical synovitis with pitting edema in a young patient is a rare observation. We hereby report a case of a remitting seronegative symmetrical synovitis with pitting edema in a young male affected by no rheumatological diseases in the past, typically fulfilling the diagnostic criteria and well responded to low-dose steroid therapy. The salient features of the present case in terms of age, remitting seronegative symmetrical synovitis with pitting edema possibly related to undifferentiated arthropathy, reactive arthritis, or diabetes mellitus.

show abstract

“…Conditions including systemic lupus erythematosus, Sjögren's syndrome, polyarteritis nodosa, and ankylosing spondylitis have been associated with RS3PE [24][25][26][27]. Infections including parvovirus and Streptobacillus moniliformis have been reported to cause RS3PE [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Nivolumab induced remitting seronegative symmetrical synovitis with pitting edema in a patient with melanoma: a case report

et al. 2018

View full text Add to dashboard Cite

Background: Novel immune checkpoint inhibitors have been often utilized for different types of malignancies as salvage therapy with varying success. One obstacle to immune checkpoint inhibitor use is the higher incidence of immune-mediated side effects that can prompt discontinuation of therapy. Remitting seronegative symmetrical synovitis with pitting edema has been described with immune checkpoint inhibitors only once previously. We report a case of a patient who developed remitting seronegative symmetrical synovitis with pitting edema related to immune checkpoint inhibitor therapy and stress that these symptoms can be managed without cessation of immune checkpoint inhibitor therapy. Case presentation: We present a 70-year-old white man who presented with 4 months of progressive inflammatory arthritis with pitting edema. He had been started on nivolumab therapy for his metastatic melanoma with excellent response prior to symptom onset. The symptoms started in his knees and subsequently involved both hands and feet. On evaluation, he was wheelchair bound and completely dependent for all activities of daily living. Evaluation revealed negative serological testing and plain film imaging. Ultrasound demonstrated diffuse flexor tenosynovitis and soft tissue swelling, and a diagnosis of remitting seronegative symmetrical synovitis with pitting edema was made. He was treated with orally administered corticosteroids (0.5 mg/kg per day) which improved his symptoms significantly and allowed him to regain prior independent functioning. His corticosteroids were tapered (0.15 mg/kg per day) but not discontinued and his nivolumab treatment was not interrupted. In follow up he continued to have stable control of his melanoma as well as his remitting seronegative symmetrical synovitis with pitting edema. Conclusions: In conclusion we present the first case of nivolumab-induced remitting seronegative symmetrical synovitis with pitting edema that is controlled by maintenance low-dose orally administered corticosteroids allowing for continuation of nivolumab therapy. Clinicians who encounter mild-to-moderate immune checkpoint inhibitor immune-mediated adverse effects can consider maintaining immune checkpoint inhibitor therapy with concomitant low-dose corticosteroids rather than abrupt cessation of the immune checkpoint inhibitor.

show abstract

Synovitis with pitting edema as the presenting manifestation of systemic lupus erythematosus

Cited by 10 publications

References 9 publications

RS3PE: Clinical and Research Development

RS3PE: Clinical and Research Development

An unusual case of remitting seronegative symmetrical synovitis with pitting edema: Case report and literature review

Nivolumab induced remitting seronegative symmetrical synovitis with pitting edema in a patient with melanoma: a case report

Contact Info

Product

Resources

About