A Case of Paraneoplastic Syndrome

ABSTRACT

A 73-year-old woman was admitted with fever, arthralgia, and swelling of the hands and feet. She was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) accompanied by breast carcinoma, a type of paraneoplastic syndrome. Treatment with acetaminophen and diclofenac sodium for fever and arthralgia proved minimally effective. She experienced great difficulty in walking and grasping smoothly due to edema; therefore, clarithromycin (CAM) was added in expectation of its anti-inflammatory effects. About 10 days after starting CAM treatment, pitting edema improved considerably. Fever and arthralgia did not improve satisfactorily after resection of breast carcinoma, and thus she was successfully treated with low-dose prednisolone (PSL). This case suggests that other than surgical resection of the neoplasm, CAM and PSL treatment for RS3PE associated with neoplastic disease may be effective.