Remitting seronegative symmetrical synovitis with pitting edema:a retrospective analysis of 8 cases / 基础医学与临床

ABSTRACT

Objective To investigate the clinical features of Remitting Seronegative Symmetrical Synovitis with Pitting Oedema(RS3PE),especially it’s association with malignancy. Methods The clinical data of eight RS3PE patients hospitalized during Jan 2003 and June 2007 in Peking Union Medical College Hospital were reviewed. The clinical characteristics, laboratory tests, response to treatment as well as the outcome were studied. Among the 8 patients, five were male and 3 were female,the mean age of RS3 PE onset was 60.9 (38～79yr). 5 had idiopathic RS3PE without underlying disease, and 3 presented associated neoplasm. Results All patients had symmetrical polyarthritis and pitting edema on the dorsum of hands and/or feet. Extra-articular symptoms were more conspicuous in patients complicated by neoplasm. Serum RF、AKA、APF and anti-CCP antibody were all negative. antinuclear antibodies (ANA) was positive with low titer in five cases. Hand and foot radiographs did not show bone erosion in all cases. After steroid and/or immunosuppressive treatment, 2 cases exhibited persistent remission of articular symptoms and edema, whereas relapses occurred 6, 7 and 36 months respectively after the initial diagnosis in 3 cases who had been pathologically confirmed as having Non-Hodgkin-Lymphoma and thereby received periodical chemotherapy. Conclusion RS3PE is a group of clinical manifestations with prominent heterogeneity, therefore intensive follow-up is necessary, and the presence of systemic symptoms/ signs in RS3PE patients alert the physician for the potential concomitant malignancy.