Remitting, seronegative, symmetric synovitis with pitting edema rs3pe is a syndrome with an acute onset, benign course characterized by rheumatoid factor. Unilateral rs3pe in a patient of seronegative rheumatoid. Remitting symmetrical seronegative synovitis and pitting edema. Treatment of a patient with remitting seronegative. The clinical diagnosis was remitting seronegative symmetrical synovitis with pitting edema rs 3 pe syndrome. Numerous diseases are associated with rs3pe, including neoplasia, infection, parkinsons disease, and other rheumatic diseases. Oct 31, 2003 we report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma. Idiopathic remitting seronegative symmetrical synovitis. A 75yearold male who was undergoing chronic hemodialysis developed abruptonset pitting edema and pain in the dorsum of both hands and feet. If no underlying disorder can be identified idiopathic rs3pe, this entity has an excellent prognosis and responds well to treatment. Synovitis with pitting edema rs3pe syndrome which is characterized by. Laboratory diagnosis blood test results were as follows. We report 2 elderly patients who present with a relatively acute onset of a severe symmetrical synovitis affecting the flexor digitorum tendon sheaths and wrist joints with pitting edema of the dorsum of both hands. Remitting seronegative symmetrical synovitis with pitting edema bioinformatics tool laverne is a handy bioinformatics tool to help facilitate scientific exploration of related genes, diseases and pathways based on cocitations.
Rs3pe is a type of benign seronegative polyarthritis that affects older people and is characterised by sudden onset of oedema and swelling of the dorsum of the hands with. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare inflammatory condition characterized by symmetrical synovitis of the hands and feet with pitting edema. Jan 29, 2012 radiological examination showed no bony erosion. Clinical characteristics of patients with remitting. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome daniel j. To contrast and compare the spectrum of remitting seronegative symmetrical synovitis with pitting edema rs3pe with rheumatoid arthritis ra using an illustrative case.
To investigate whether the remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome may represent a paraneoplastic disorder in a significant percentage of cases. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare syndrome consisting of acute symmetrical tenosynovitis of the hands and wrists associated with pain and marked pitting. A 77yearold man presented with poly arthritis both shoulders, knees. Remitting seronegative symmetrical synovitis with pitting edema is a rare rheumatological disorder that presents with symmetrical hand andor foot edema resembling rheumatoid arthritis. We report 2 elderly patients who present with a relatively acute onset of a severe symmetrical synovitis affecting the flexor digitorum tendon sheaths and wrist joints. Remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome is a very rare clinical entity including a tenosynovitis of the hands and wrists, and marked pitting edema on upper and lower extremities.
Mmp3 was more indicative of rs3pe syndrome symptoms than crp. Remitting seronegative symmetrical synovitis with pitting edema syndrome in a chronic hemodialysis patient article pdf available in case reports in medicine 201219. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. 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. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is characterized by symmetrical synovitis predominantly involving the hands with pitting edema of the dorsum of the hands schaeverbeke et al. Steroidresistant remitting seronegative symmetrical. Remitting seronegative symmetrical synovitis with pitting edema rs3pesyndrome. Remitting seronegative symmetrical synovitis with pitting edema rs3pe, first described in 1985 by mccarty et al, is a rare syndrome that is a subset of the seronegative symmetrical polyarthritis of older people. 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.
Dec 06, 2015 remitting seronegative symmetrical synovitis with pitting edema is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema of the back of the hands andor feet, and a. 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. Magnetic resonance imaging mri was used to describe the anatomical structures affected by inflammation in pure rs3pe syndrome. It usually affects males, is usually steroid responsive and may be paraneoplastic. Patients show excellent response to low dose steroids with complete and sustained remissions. Sjogrens syndrome presenting as remitting seronegative.
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. A detailed history and a thorough physical exam should enable the diagnosis to be elucidated in most patients. Is remitting seronegative symmetrical synovitis with pitting. Remitting seronegative symmetrical synovitis with pitting edema abbreviated rs3pe or sometimes rs 3 pe is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema of the back of the hands andor feet, and a negative serum rheumatoid factor. Though the nature of the disease still remains illusive, the outcome is excellent. Older males, 50 years of age, are predominantly affected. The objective of this study was to clarify the characterizations of polymyalgia rheumatica pmr and remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome. Remitting symmetrical seronegative synovitis and pitting edema syndrome with concomitant adenocarcinoma of the lung.
Seven patients with pmr and 12 patients with rs3pe were compared in terms of the type of onset, the complication rate of carpal tunnel syndrome cts, the initial usage of doses of prednisolone. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is an unusual inflammatory arthritis with unknown pathogenic mechanism, and is characterized by an acute onset of symmetrical synovitis with pitting edema of the hands or feet. Case report an 80yearold man presented in 2001 with a superficial spreading melanoma on the left forearm, breslow 1. Remitting seronegative symmetrical synovitis with pitting oedema. However, few cases occurring with lung cancer have been reported. Serum matrix metalloproteinase 3 in detecting remitting. The pitting edema and inflammatory response quickly subsided after lowdose prednisolone therapy. Idiopathic remitting seronegative symmetrical synovitis with. Objectiveto evaluate the outcome of patients with remitting seronegative symmetrical synovitis with pitting oedema rs3pe. Is remitting seronegative symmetrical synovitis with. This syndrome, which has a sudden onset and characterized by edema with swelling on the dorsum of the hands, synovitis on the elbows and. Large joint arthritis andor pitting oedema of the dorsum of feet coexisted in some patients. Patients have been found to respond well to low dose corticosteroids and to remain in remission paira et al.
Whether the rs 3 pe is a unique disease or syndrome has long been discussed, the real nature of the syndrome is still a matter of debate. Rs3pe stands for remitting seronegative symmetrical synovitis with pitting edema. Bucaloiu id, olenginski tp, harrington tm, remitting seronegative symmetrical synovitis with pitting edema syndrome in a rural tertiary care practice. Remitting seronegative symmetrical synovitis with pitting edema rs3pe. Aug 29, 2008 remitting seronegative symmetrical synovitis with pitting oedema syndrome, a rare inflammatory arthritis, commonly affects people in the older age group. Rs3pe is defined as remitting seronegative symmetrical synovitis with pitting edema somewhat frequently.
An 81yearold woman presented acutely with a 2day history of a severe. S ir, remitting seronegative symmetrical synovitis with pitting oedema rs3pe is a rare disorder characterized by acuteonset seronegative remitting polyarthritis with distal pitting oedema. 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. The clinical spectrum of remitting seronegative symmetrical synovitis with. Remitting seronegative symmetrical synovitis pitting edema.
Seronegative arthritis describes a group of conditions that present with inflammatory arthritis but without a positive rheumatoid factor, hence seronegative. Paraneoplastic remitting seronegative symmetrical synovitis. Myelodysplastic syndrome precedes the onset of remitting. Read remitting seronegative symmetrical synovitis with pitting edema syndrome associated with nonhodgkins lymphoma. Remitting seronegative symmetrical synovitis with pitting edema is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema swelling. Syndrome of remitting seronegative symmetrical synovitis with. We presented a 62yearold man with the diagnosis of rs3pe based on the clinical sign and laboratory data. Remitting seronegative symmetrical synovitis with pitting edema. 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. A 77yearold man presented with poly arthritis both. 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. Treatment of a patient with remitting seronegative, symmetrical synovitis with pitting oedema with a humanized antiinterleukin6 receptor antibody, tocilizumab toshio tanaka 1 department of respiratory medicine, allergy and rheumatic diseases, osaka university graduate school of medicine and 2 laboratory of immune regulation, osaka university. It can present as an acute onset polyarthritis with associated pitting oedema of the extremities.
Rheumaknowledgy remitting seronegative symmetric synovitis. Syndrome of remitting seronegative symmetrical synovitis. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is characterized by symmetrical synovitis and swelling of both the upper and lower extremities. One of the patients was positive for helicobacter pylori and the other had secondary bone metastases.
Abrupt onset of marked dorsal swelling of the hands or feet with pitting edema, wrist synovitis, and flexor finger tendinitis. It is remitting seronegative symmetrical synovitis with pitting edema. Remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome is a very rare clinical entity including a tenosynovitis of the hands and wrists, and marked pitting oedema on upper and lower extremities. We report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma. Remitting inflammatory arthritis of hands and feet affecting primarily the elderly. Neki, ankur jain, rohit bajaj, mohit manav jindal department of medicine, government medical college and guru nanak dev hospital, amritsar, india remitting seronegative symmetrical synovitis with pitting oedema rs 3pe is a rare clinical entity. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is associated with different rheumatologic and neoplastic diseases, typically in elderly men. The anatomical determinant of rs3pe is predominantly extensor tenosynovitis as revealed by magnetic resonance imaging mri. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome and rheumatoid arthritis were considered. Most cases of remitting seronegative symmetrical synovitis with pitting edema syndrome are idio pathic, but some are secondary to malignancy, autoimmune disease, or neurodegenerative disorders. Remitting seronegative symmetrical synovitis with pitting oedema syndrome, a rare inflammatory arthritis, commonly affects people in the older age group. 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 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. Evaluation of seronegative arthritis differential diagnosis. This is the first case to be reported of remitting seronegative symmetrical synovitis with pitting edema syndrome rs3pe under nivolumab. Pleural and pericardial effusions are unusual complications in idiopathic remitting seronegative symmetrical synovitis with pitting edema syndrome. Remitting seronegative symmetrical synovitis with pitting. We hereby report a case of unilateral rs3pe in a patient of seronegative rheumatoid arthritis which was.
The relevant english literature of rs3pe was searched using the keywords rs3pe alone and in combination with terms such as neoplasia and rheumatic disease. 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. Objectiveto determine the clinical characteristics of patients with pure remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome, and to investigate its relation with polymyalgia rheumatica pmr. Explore more on remitting seronegative symmetrical synovitis with pitting edema below. Sep 26, 2016 remitting seronegative symmetrical synovitis with pitting edema syndrome has been reported to be associated with malignant tumors.
Remitting seronegative symmetrical synovitis with pitting oedema rs3pe was first described by mccarty et al. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome was first reported by mccarty et al. Explore more on remitting seronegative symmetrical synovitis. Remitting seronegative symmetrical synovitis with pitting edema rs 3 pe syndrome is a distinct disease entity that was first described by mccarty et al. 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. Rs3pe remitting seronegative symmetrical synovitis with.
Remitting seronegative symmetrical synovitis with pitting edema syndrome has been reported to be associated with malignant tumors. Biochemical analysis disclosed increased creactive protein, and negative rheumatoid factor and antinuclear antibody. P142 paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe. Computed tomography and gallium scintigraphy revealed no active infection or neoplasms. Comparison between polymyalgia rheumatica and remitting. Rs3pe remitting seronegative symmetrical synovitis with pitting edema. We report a patient with remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome and elevation of matrix metalloproteinase 3 mmp3. In the latter, the clinical picture of rs3pe developed after surgical intervention for the primary lesion.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare form of inflammatory arthritis, most often affecting elderly individuals and. Pdf remitting seronegative symmetrical synovitis with. It is classically described as symmetrical involvement of both upper extremities. How is remitting seronegative symmetrical synovitis with pitting edema abbreviated. Remitting seronegative symmetrical synovitis with pitting edema is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema of. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare but wellreported clinical entity.
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