The paraneoplastic meaning of r3spe remitting seronegative. Cancer has been reported in association with this syndrome since 1985. Patients diagnosed with rs3pe syndrome at the medical college of wisconsin before 1995 were telephoned and asked about their rheumatologic course since initial diagnosis of rs3pe and whether. Ab1034 the treatment approach for the management of. Abrupt onset of symmetric inflammatory arthritis and edema, as seen on the dorsum of this 72yearold mans hand, is characteristic of remitting seronegative symmetric synovitis with pitting edema or rs3pe. Eight elderly men and two elderly women presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting edema of the dorsum of both hands and both feet. We presented a 62yearold man with the diagnosis of rs3pe based on the clinical sign and laboratory data. Objectiveto evaluate the outcome of patients with remitting seronegative symmetrical synovitis with pitting oedema rs3pe. If you have problems viewing pdf files, download the latest version of adobe reader.
Asymmetrical involvement had also been reported, but unilateral presentation is very rare. Rs 3 pe syndrome is characterized by symmetrical and acute synovitis, marked pitting edema, the absence of rheumatoid arthritis, increased acute phase reactants, lack of bony erosions on radiography, and a. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is an uncommon dis order, characterized by an. The paraneoplastic meaning of r3spe remitting seronegative simmetrical synovitis with pitting edema syndrome. Claiming your author page allows you to personalize the information displayed and manage publications all current information on this profile has been aggregated automatically from publisher and metadata sources. Remitting symmetric seronegative synovitis with pitting edema. Remitting symmetrical seronegative synovitis and pitting edema rs3pe syndrome is a rheumatologic disease affecting elderly patients accompanied by symmetric synovitis of small joints of the hand andor foot, which is characterized by pitting edema in the dorsum of the hand andor foot. Remitting seronegative symmetrical synovitis with pitting edema rs3pe. Although there are overlapping clinical manifestations between rs3pe, elderlyonset rheumatoid arthritis, and polymyalgia rheumatica, rs3pe has distinct characteristics. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare clinical entity that is easily missed due to lack of knowledge. Onset of seven of the ten cases could be pinpointed almost.
Remitting seronegative symmetrical synovitis with pitting oedema rs3pe is a rheumatic disease clinically characterised by the sudden onset of symmetrical distal polytenosynovitis, pitting oedema on the dorsum of the hands andor feet, no rheumatoid factor rf or autoantibodies, and the absence of joint erosions on plain radiographs. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Remitting seronegative symmetric synovitis with pitting. We hereby report a case of unilateral rs3pe in a patient of seronegative rheumatoid arthritis which was. In the latter, the clinical picture of rs3pe developed after surgical intervention for the primary lesion. To compare clinical features of patients with remitting seronegative symmetrical synovitis with pitting edema rs3pe and patients with polymyalgia rheumatica pmr and to explore the purported association between rs3pe and malignancy. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare inflammatory arthritis characterized by acute onset symmetric distal tenosynovitis and pitting edema of hands and feet. It dramatically responds to low doses of glucocorticoids. Remitting seronegative symmetrical synovitis with pitting oedema rs3pe is a rare rheumatologic condition frequently missed but easily treated. Case study by international journal of medical science and public health. A case of remitting seronegative symmetrical synovitis. Computed tomography and gallium scintigraphy revealed no active infection or neoplasms. We describe a case of rs3pe and explore the literature surrounding this arthritis.
We herein report a 62yearold man with idiopathic pulmonary fibrosis who developed remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome during followup. Clinical characteristics of patients with remitting. It commonly has a benign course leading to remission but in some cases has been associated with neoplastic, other rheumatic, or comorbid diseases. After 6 months she came to the clinic showing important improvement and no hand edema or synovitis. Remitting seronegative symmetric synovitis with pitting edema rs3pe dx. Ab1034 the treatment approach for the management of remitting. Rs3pe can be associated with neoplasia and various rheumatic conditions, suggesting that it may be. We report a patient with remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome and elevation of matrix metalloproteinase 3 mmp3. Syndrome of remitting seronegative symmetrical synovitis. We perform a systematic electronic search of medline and pubmed for. A new articular syndrome described as immunrelated side effect of immunotherapy. J med oncl ther 2016 olume 1 ssue 2 73 several months, as average. Remitting seronegative symmetrical synovitis with pitting edema rs3pe, also described as puffy edematous hand syndrome, is a rare rheumatological condition characterized by symmetrical tenosynovitis of the upper andor lower extremities with acute onset of pitting edema of the dorsa of the hands and thus gives the appearance of boxing gloves.
Hunter eight elderly men and two elderly women presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting edema ofthe dorsum both hands and both feet. Remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome mainly affects elderly men and responds well to steroids. Unilateral rs3pe in a patient of seronegative rheumatoid. An abrupt onset of pitting edema of the dorsum of the hands associated with synovitis of the wrist carpus, small joints, and tendon sheaths are described clinical features. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is associated with different rheumatologic and neoplastic diseases, typically in elderly men. One of the patients was positive for helicobacter pylori and the other had secondary bone metastases. Its relapse is extremely rare in the benign forms and, when present, it presents only after several months 5. Paraneoplastic remitting seronegative symmetrical synovitis. Patients diagnosed with rs3pe syndrome at the medical college of wisconsin before 1995 were telephoned and asked about their rheumatologic course since initial diagnosis of rs3pe. Remitting seronegative symmetrical synovitis pitting edema. Remitting seronegative symmetrical synovitis with pitting.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare but wellreported clinical entity. A diagnosis of remitting seronegative symmetrical synovitis with pitting edema syndrome rs3pe was made. Mmp3 was more indicative of rs3pe syndrome symptoms than crp. An unusual case of remitting seronegative symmetrical. Serum matrix metalloproteinase 3 in detecting remitting. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is a definite subset of the seronegative symmetrical polyarthritis of the aged, characterized by dramatic pitting edema of the hands, male predominance, old age and exquisite response to. The diagnosis of remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome was suggested and, considering the possibility of an underlying occult malignancy, a chest radiography was performed. Remitting seronegative symmetrical synovitis with pitting edema. Seronegatif pitting odemli simetrik sinovit sendromu. Bir olgu sunumu abst ract rs3pe remitting seronegative, symmetric synovitis with pitting edema is a benign, seronegative syndrome, with an. Nivolumab induced remitting seronegative symmetrical. Jun 26, 2015 remitting seronegative symmetrical synovitis with pitting edema or rs3pe is a rare elderlyonset rheumatic syndrome. To investigate whether the remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome may represent a paraneoplastic disorder in a significant percentage of cases. Bir olgu sunumu abst ract rs3pe remitting seronegative, symmetric synovitis with pitting edema is a benign, seronegative syndrome, with an acute onset.
In rs3pe syndrome, antinuclear antibody ana, rheumatoid factor rf, and anticyclic citrullinated. Remitting seronegative symmetrical synovitis and pitting. Ensure your research is discoverable on semantic scholar. Oct 31, 2003 we report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma. We report a case of remitting seronegative symetrical synovitis with pitting edema rs3pe syndrome induced by nivolumab. Relapsing seronegative symmetrical synovitis with pitting edema and feltys syndrome are discussed as disorders of idiopathic, aberrant immune dysregulation. Abrupt onset of marked dorsal swelling of the hands or feet with pitting edema, wrist synovitis, and flexor finger tendinitis. Large joint arthritis andor pitting oedema of the dorsum of.
Pdf remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare form of paraneoplastic tenosynovitis, which is more prone to. Remitting seronegative symmetrical synovitis with pitting oedema associated with lung. Pdf remitting seronegative symmetrical synovitis with. To describe the clinical and laboratory features and outcome of 6 patients presenting with remitting seronegative symmetrical synovitis with pitting edema rs3pe revealing a solid tumor. Remitting seronegative symmetrical synovitis and pitting edema rs3pe is an uncommon condition that is characterized as an acute polysynovitis associated with pitting edema that tends to affect. Pd1 inhibitors have revolutionized the treatment of advanced melanoma but are responsible for immunerelated toxicity. For language access assistance, contact the ncats public information officer. It isusuallyresponsivetolowdoseglucocorticoidsand occurs more often in older individuals with a male predominance.
In 1985 and 1990 mccarty et aldescribed 23 patients with remitting symmetrical synovitis of upper limbs associated with pitting oedema of the dorsum of hands. Remitting seronegative symmetrical synovitis with pitting oedema 73. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome daniel j. Remitting seronegative symmetrical synovitis with pitting edema or sometimes rs 3 pe is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema swelling of the back of the hands andor feet, and a negative serum rheumatoid factor. Remitting seronegative symmetrical synovitis with pitting edema or rs3pe is a rare elderlyonset rheumatic syndrome. Rs3pe remitting seronegative symmetrical synovitis with. Remitting seronegative symmetrical synovitis with pitting edema is an uncommon elderlyonset rheumatic disease characterized by tenosynovitis of both flexor and extensors tendons at the wrist and at the feet.
Syndrome of remitting seronegative symmetrical synovitis with pitting edema rs3pe tekrarlay. Pdf syndrome of remitting seronegative symmetrical. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome was first reported by mccarty et al. We report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is a rare clinical entity characterized by the sudden onset of inflammatory arthritis and marked pitting edema on. Remitting seronegative symmetrical synovitis with pitting edema is a diseasesyndrome characterized by an acute onset of polyarthritis with pitting edema, negative rheumatoid factor, absence of joint erosions on radiographs, synovitis suggested by usgmri, and an exquisite response to lowdose steroids, with a sustained longterm response. Pdf to determine the clinical characteristics of patients with pure remitting seronegative symmetrical synovitis with pitting oedema rs3pe. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome in an elderly spanish patient. Remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome. It commonly has a benign course leading to remission but in some cases has been associated with neoplastic, other rheumatic, or comorbid. Synovitis with pitting edema rs3pe syndrome which is characterized by. The clinical diagnosis was remitting seronegative symmetrical synovitis with pitting edema rs 3 pe syndrome. Case of remitting seronegative symmetrical synovitis with. Remitting symmetrical seronegative synovitis and pitting. Health, general dropsy care and treatment case studies diagnosis. Hunter eight elderly men and two elderly women presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting. Rs3pe can be associated with neoplasia and various rheumatic conditions, suggesting.
Rs3pe remitting seronegative symmetrical synovitis with pitting edema syndrom. Background remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is an acute inflammatory polyartritis and palpable pitting edema of the elderly patients. It is a rare clinical syndrome that occurs predominantly in elderly men and is characterized by rapidonset symmetrical distal teno andor joint synovitis, marked pitting oedema over the joints involved, especially the dorsum of the hands and feet. A case of remitting seronegative symmetrical synovitis with. Rs3pe remitting seronegative, symmetric synovitis with pitting edema is a benign, seronegative syndrome, with an acute onset of pitting edema on the dorsum of both hands and feet, which affects predominantly peripheral joints such as wrists and ankles symmetrically. Pdf an unusual case of remitting seronegative symmetrical. However, because the joint swelling and pitting edema did not improve, p. Patients with rs3pe who presented with a solid tumor and who had been seen between january 1, 1994, and december 31, 1996, were included. Remitting seronegative symmetrical synovitis with pitting edema rs 3 pe syndrome is a distinct disease entity that was first described by mccarty et al. Since this syndrome can resemble other diseases, its diagnosis is a significant challenge. Remitting seronegative symmetrical synovitis with pitting edema rs3pea rare disease. Remitting seronegative symmetrical synovitis with pitting edema in a patient with kaposi sarcoma. The erythema disappeared after diclofenac sodium administration. Remitting, seronegative, symmetric synovitis with pitting edema rs3pe is a syndrome with an acute onset, benign course characterized by rheumatoid factor.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare form of inflammatory arthritis, most often affecting elderly individuals and. Syndrome of remitting seronegative symmetrical synovitis with. Rs 3 pe syndrome is characterized by symmetrical and acute synovitis, marked pitting edema, the absence of rheumatoid arthritis, increased acute phase reactants, lack of bony erosions on radiography, and a benign. Remitting seronegative symmetrical synovitis with pitting oedema. It is classically described as symmetrical involvement of both upper extremities. In conclusion we present the first case of nivolumabinduced remitting seronegative symmetrical synovitis with pitting edema that is controlled by maintenance lowdose orally administered corticosteroids allowing for continuation of nivolumab therapy. Remitting seronegative symmetrical synovitis with pitting edema rs 3pe syndrome in a tertiary care hospital. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare condition in the elderly and can appear as a first presentation of various types of rheumatic and malignant diseases.
The workup of this patient was essentially negative for other types of. Pulmonary infiltrations were detected concomitantly with the development of rs3pe syndrome, and prednisolone improved both the pulmonary and extrapulmonary lesions. Each chapter makes accessible a collective experience of a rare rheumatologic disease by encompassing historical and current case reports, clinical descriptions. Remitting symmetric seronegative synovitis with pitting.
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