Sjogren's Syndrome Presenting as Remitting Seronegative Symmetric Synovitis with Pitting Edema(RS3PE)

Remitting seronegative symmetric synovitis with pitting edema (RS3 PE) syndrome is characterized by symmetrical and acute synovitis, pitting edema, the absence of rheumatoid factor, increased acute phase reactants, lack of bony erosions on radiography, and benign and short clinical course. Half of all patients with Sjogren's syndrome experience arthritis during the disease course. We here describe the first case of Sjogren's syndrome presenting as RS3PE. She had swelling in knees, ankles, and wrists. After then the swelling spread to her lower legs, feet, face, and both hands. She was admitted to another hospital and was suspected of lupus or rheumatoid arthritis. Three months later, she had dry mouth and had lower lip biopsy. She was admitted to this hospital due to development of swelling in face and lower legs for 3 days. On physical examination, she had pitting edema in both hands and feet dorsum. Laboratory test showed elevated erythrocyte sedimentation rate, positivity of rheumatoid factor, anti-nuclear antibody, and anti-Ro antibody. There was no erosion in the hands radiography. Schirmer's test and lip biopsy was compatible with Sjogren's syndrome. She was diagnosed RS3 PE and Sjogren's syndrome. She was begun with prednisolone and her symptoms improved gradually.

Interaction of rheumatoid factor and Entamoeba histolytica

Testes para citotoxicidade e lise amebiana foram utilizados para deminstrar uma possível interaçäo entre o fator reumatóide e a Entamoeba histolytica. A atividade citotóxica amebiana foi inibida pela IgG antiameba de coelho purificada através de cromatografia. Constatou-se inibiçäo aumentada com IgG antiameba de coelho mais fator reumatóide. A mesma inibiçäo acentuada da atividade citotóxica amebiana pôde ser constatada quando se substituiu o fator reumatóide por sor humano normal, inativado pelo calor, como controle. Cerca de 50% de lise amebiana ocorreu quando as amebas foram misturadas com soro normal humano como fonte de complemento. A lise amebiana aumentou para 60% quando incubadas com soro humano normal, acrescido de anticorpos humanos antiameba. Nenum aumento adicional pode ser obtido pela adiçäo de fator reumatóide. Usando IgG antiameba de coelho em vez de anticorpos humanos, a proporçäo de lise näo aumentou. A incubaçäo de amebas com soro humano normal, IgG antiameba de coelho e fator reumatóide reduziu acentuadamente a lise amebiana. O fator reumatóide näo teve efeito na atividade citotóxica amebiana, nem na lise amebiana mediada pelo complemento in vitro