The rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a clinic where primary care physicians are working in Japan

Okumura, Toshikatsu; Tanno, Satoshi; Ohhira, Masumi; Nozu, Tsukasa

doi:10.1007/s00296-011-1849-3

Cited by 35 publications

(26 citation statements)

References 31 publications

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“…According to a study of 3347 patients of aged 50 and greater in a single medical center in Japan, three patients were diagnosed with RS3PE, with a resultant disease incidence rate of 0.09 % [14]. Other elderlyonset rheumatic conditions, such as polymyalgia rheumatica (PMR) and elderly-onset RA, can have overlapping clinical pictures with RS3PE; however, they are dissimilar in certain clinical aspects.…”

Section: Rs3pe Is Distinct Entity and Differs From Elderly-onset Rheumentioning

confidence: 99%

RS3PE: Clinical and Research Development

Altman

Yao

2015

Curr Rheumatol Rep

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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.

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Section: Rs3pe Is Distinct Entity and Differs From Elderly-onset Rheumentioning

confidence: 99%

RS3PE: Clinical and Research Development

Altman

Yao

2015

Curr Rheumatol Rep

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“…It is reportedly more common among males age 60 and older [18,19]. The incidence of RS3PE has been reported at 0.09% in a large Japanese cohort [20]. Multiple subtypes of RS3PE have been described, including an idiopathic form, as well as forms which may coexist with other autoimmune diseases such as Sjögren's syndrome.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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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.

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“…As the authors have recently discussed,10–13 the hospital, which has 602 beds, has approximately 250 doctors who together work to cover almost all medical problems. Of these doctors, four or five primary care physicians work in the Department of General Medicine.…”

Section: Methodsmentioning

confidence: 99%

High rate of smoking in female patients with Mondor's disease in an outpatient clinic in Japan

Okumura¹,

Ohhira²,

Nozu³

2012

IJGM

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Purpose:Little is known about the epidemiology of Mondor’s disease. The aim of this study was to analyze the clinical features of Mondor’s disease in an outpatient clinic where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease.Patients and methods:The data for consecutive outpatients who were new visitors to the Department of General Medicine in the teaching hospital (Asahikawa Medical University Hospital) at Asahikawa Medical University, Asahikawa, Hokkaido, Japan, between April 2004 and March 2012 were analyzed. Parameters such as age, sex, diagnosis, and clinical presentation were investigated.Results:During the 8-year period covered in this study, six (0.07%) out of 8767 patients were diagnosed as having Mondor’s disease. All of these patients with Mondor’s disease were female, and the mean age was 41 plus or minus 12 years; the overall rate of Mondor’s disease in all female patients involved in this study was 0.12%. The patients complained of pain and a cord-like structure in the anterolateral thoracoabdominal wall. The painful mass had persisted for 1–4 weeks before presenting at the Department of General Medicine and it disappeared within a couple of weeks. Current smoking was significantly higher in the patients with Mondor’s disease than in the age-matched female patients without Mondor’s disease who were also evaluated in this study.Conclusion:These results suggest that a high rate of smoking in middle-aged females may be a characteristic feature of Mondor’s disease. These epidemiological data may be useful in detection of the disease in the primary care setting in Japan.

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The rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a clinic where primary care physicians are working in Japan

Cited by 35 publications

References 31 publications

RS3PE: Clinical and Research Development

RS3PE: Clinical and Research Development

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

High rate of smoking in female patients with Mondor's disease in an outpatient clinic in Japan

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