S hort stature, h yperextensibility, o cular depression deeply set eyes, r ieger anomaly, and t eething delay. The erythema disappeared after diclofenac sodium administration. Patients with idiopathic rs3pe showed an excellent response to low doses of corticosteroids compared to the poor response to rs3pe in association with neoplasia. Rs3pe syndrome is a rare but well defined syndrome known to be.
Aug 29, 2008 rs3pe syndrome can be associated with both solid tumours like gastric, pancreatic and haematological malignancies like nonhodgkins lymphoma. 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. We hereby report a case of unilateral rs3pe in a patient of seronegative rheumatoid arthritis which was. Patients show excellent response to low dose steroids with complete and sustained remissions. Pdf remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare polyarthritis syndrome affecting mainly older adults. By running the prexviewer software you acknowledge having read the disclaimer.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe is associated with different rheumatologic and neoplastic diseases, typically in elderly men. To evaluate changes in echotexture of normal tendons at different frequencies and establish an anatomic correlation for fibrillar echoes, normal calcaneal tendons were examined in vitro at 7. These pages contain background information on some of the most common medications and therapies used to treat rheumatic disease, such as how they work, common dosages, safety tips, possible side effects, risks and things you should discuss with your health care providers if you are taking or considering these treatments. Oct 31, 2003 we report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma. Mr imaging findings in brachial plexopathy with thoracic outlet syndrome a. Remitting seronegative symmetrical synovitis with pitting oedema syndrome, a rare inflammatory arthritis, commonly affects people in the older age group. Although the pathogenesis of rs3pe remains unknown, overproduction of il6 has been demonstrated to contribute to its development 2, 3. Idiopathic remitting seronegative symmetrical synovitis with. The symptoms of polymyalgia rheumatica seem to be related to synovitis of proximal joints and extraarticular synovial. Rs3pe is listed in the worlds largest and most authoritative dictionary database of abbreviations and acronyms. Therefore, we started treatment with vancomycin 1 gday and clindamycin 600. Rs3pe as abbreviation means remitting seronegative symmetrical synovitis with pitting edema. Objective to 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.
Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome. Rs3pe remitting seronegative symmetrical synovitis with pitting edema. 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. It may occasionally be the harbinger of an underlying malignancy.
J med oncl ther 2016 olume 1 ssue 2 73 several months, as average. Rs3pe stands for remitting seronegative symmetrical synovitis with pitting edema. Dear editor, a 48yearold female presented with pain and swelling in the bilateral proximal interphalangeal pip, metacarpophalangeal mcp and wrist joints for the past 20 days. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare clinical entity that is easily missed due to lack of knowledge. Remitting seronegative symmetrical synovitis with pitting. The term short syndrome was first created to reflect several of the features of the original reported cases. The journal of rheumatology february 2007, 34 2 452453. Etiology and pathogenesis of this disease is not fully understood and usually seen over 50 years of age and characterized by. An unusual case of remitting seronegative symmetrical synovitis with pitting edema. Rsts is characterized by growth delays, distinctive facial features, intellectual disability with an average iq of 3651, abnormally broad and often angulated thumbs and great toes halluces, and feeding difficulties dysphagia. Case report open access rs3pe syndrome developing during the course of probable toxic shock syndrome. The syndrome was reported to be associated with hla b7 3 and hla a2 haplotypes. Numerous additional cases have since been reported. S ir, rs3pe is an inflammatory disorder of unknown aetiology that affects elderly persons.
The key to successful management of rheumatoid arthritis ra is the early diagnosis of inflammatory arthritis and early specialist referral to access appropriate pharmacological and multidisciplinary team therapies, reducing the risk of permanent joint damage and systemic complications. 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 rs3pe is a. Unilateral rs3pe in a patient of seronegative rheumatoid.
Ab1034 the treatment approach for the management of. If no underlying disorder can be identified idiopathic rs3pe, this entity has an. Treatment of a patient with remitting seronegative. Rs3pe is defined as remitting seronegative symmetrical synovitis with pitting edema somewhat frequently. The literature only includes a few cases of unilateral rs3pe syndrome,4,5 but in our opinion, the unilateral involvement of this syndrome is not as rare as has been reported. Mar 07, 2016 there is no formal criteria for diagnosis yet. It commonly occurs in elderly individuals and is remitting, seronegative namely rheumatoid factornegative, symmetrical, and characterized by synovitis with pitting edema on the dorsum of the hands and feet. And now, its connected to the adobe document cloud.
The paraneoplastic meaning of r3spe remitting seronegative simmetrical synovitis with pitting edema syndrome. If no underlying disorder can be identified idiopathic rs3pe, this entity has an excellent prognosis and responds well to treatment. It includes content provided to the pmc international archive by participating publishers. The aim of this article is to summarise the main management options suggested by american. The patient was thus diagnosed with rs3pe syndrome, for which he satisfied all four. Increased serum concentration of il6 has been observed in patients with rs3pe 2, 3, and therefore il6 inhibition with tocilizumab might constitute a novel strategy for treatment of rs3pe. It can present as an acute onset polyarthritis with associated pitting oedema of the extremities. Jul 20, 2016 remitting seronegative symmetrical synovitis with pitting edema syndrome is characterized by symmetrical synovitis with pitting edema in the dorsum of the hands or feet. Ga scintigraphy showed synovitis of the bilateral wrists. Rs3pe has also been observed in the form of a paraneoplastic syndrome in association with solid organ malignancies, and rarely, hematological malignancies 8. Polymyalgia rheumatica and giantcell arteritis the lancet. Here, we describe a 67yearold man with mds with refractory anemia who developed rs3pe syndrome 3 months after the diagnosis of mds. The first page of the pdf of this article appears above. The study of rs3pe syndrome has been mentioned in research publications which can be found using our bioinformatics tool below.
Remitting symmetric seronegative synovitis with pitting. We describe the characteristics and outcome of inflammatory arthritis in patients with myelodysplastic syndrome mds in a french multicenter retrospective study. Every day thousands of users submit information to us about which programs they use to open specific types of files. The disorder might present as an isolated condition or in association with giant cell arteritis. Inflammatory arthritis in patients with myelodysplastic synd. Klippeltrenaunay syndrome and spinal arteriovenous malformations. Coexistence of rs3pe syndrome and ankylosing spondylitis. Rs3pe syndrome remitting symmetrical seronegative synovitis with pitting edema was first described by mc carthy in 1985. Cantini f, salvarani c, olivieri i, benozzi l, macchioni l, nicolli l, et al. Rs3pe syndrome developing during the course of probable toxic. Remitting seronegative symmetrical synovitis with pitting edema. Remitting seronegative symmetrical synovitis with pitting oedema. The bpl is a part of the peripheral nervous system. Find, read and cite all the research you need on researchgate.
What is shorthand of remitting seronegative symmetrical synovitis with pitting edema. Several diseases, including inflammatory rheumatic and autoimmune. Clinicians must recognize rs3pe syndrome when they come across it in connection with. 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. One of the patients was positive for helicobacter pylori and the other had secondary bone metastases. Increases in acute phase reactants are typical of polymyalgia rheumatica. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is characterized by symmetrical synovitis with pitting edema in the dorsum of the hands or feet, predominantly involving the hands. Rs3pe is a symmetrical synovitis of rapid installation, with pitting edema on the back of the hands, no joint destruction and the absence of rheumatoid factor, predominantly found in men over 50. Short syndrome genetic and rare diseases information center. While we do not yet have a description of the s3d file format and what it is normally used for, we do know which programs are known to open these files. 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. For months i ran around do doctors in florida and no one could figure it out. Indeed, reported here, tocilizumab treatment resulted in a remarkable suppression of clinical symptoms, accompanied by a reduction in mmp3 levels as well.
Case of remitting seronegative symmetrical synovitis with. The patient was thus diagnosed with rs3pe syndrome, for which he satisfied all. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. It is classically described as symmetrical involvement of both upper extremities. Rs3pe remitting seronegative symmetrical synovitis with. It was formerly considered as a subset of rheumatoid arthritis ra, but is now regarded as a distinct disease syndrome. Remitting seronegative symmetrical synovitis with pitting edema rs3pe is a rare but wellreported clinical entity. Ruben queiro, mercedes alperi, jose luis riestra and javier ballina. A diagnosis of remitting seronegative symmetrical synovitis with pitting edema syndrome rs3pe was made.
Remitting seronegative symmetrical synovitis with pitting oedema rs3pe was first described by mccarty et al. It commonly has a benign course leading to remission but in some cases has been associated with neoplastic, other rheumatic, or comorbid. Rs3pe syndrome remitting seronegative symmetrical synovitis with pitting oedema occurs mostly in elderly people over 60 years of age and is demonstrable on the dorsum of the hands. Disease bioinformatics research of rs3pe syndrome has been linked to edema, synovitis, pitting edema, remitting seronegative symmetrical synovitis with, arthritis. Europe pmc is an elixir core data resource learn more. While we do not yet have a description of the s3p file format and what it is normally used for, we do know which programs are known to open these files. Polymyalgia rheumatica and giantcell arteritis are closely related disorders that affect people of middle age and older. I finally found a rheumatologist, who, after taking sonogram and mris of wrists and hands, has concluded i have it. It dramatically responds to low doses of glucocorticoids. Idiopathic remitting seronegative symmetrical synovitis. Adobe acrobat reader dc download free pdf viewer for. This website uses cookies to improve your experience while you navigate through the website. Diseases and conditions american college of rheumatology.
Remitting seronegative symmetrical synovitis with pitting oedema rs3pe syndrome. The aetiology of the disease is still not well known but we can classify it. People with this condition have an extra piece of genetic material duplication on chromosome 16 at a location designated p. There are no validated international guidelines available for the diagnosis and treatment of pmr. These symptoms show a good response to lowdose corticosteroids, and remission can be maintained. Pdf remitting seronegative symmetrical synovitis with pitting oedema syndrome, a rare. Its the only pdf viewer that can open and interact with all types of pdf content, including. Paraneoplastic remitting seronegative symmetrical synovitis. Rs3pe syndrome developing during the course of probable. It is a rare type of seronegative polyarthritis occurring in the. Adobe acrobat reader dc software is the free global standard for reliably viewing, printing, and commenting on pdf documents. How is remitting seronegative symmetrical synovitis with pitting edema abbreviated. The exact pathophysiology of rs3pe remains unknown. Pdf remitting seronegative symmetrical synovitis with pitting.
In addition to the isolated or pure type which probably forms part of the. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome was first reported in 1985 by mccarty et al. Please refer to prexion3d viewer software of the prexion3d scanner for clinical diagnostics. The differential diagnosis of rs3pe syndrome includes rheumatoid arthritis ra, complex regional pain syndrome, gout arthritis, systemic lupus erythematosus sle, systemic. Remitting seronegative symmetrical synovitis with pitting oedema 73. Rubinstein taybi syndrome nord national organization for. Rubinsteintaybi syndrome rsts is a rare genetic disorder that affects many organ systems. The rs3pe syndrome is the inflammatory rheumatisms of old age, being related to rheumatoid arthritis. The term synovitis is used due to the symmetric polysynovitis of the joints and tendon sheaths of the fingers, associated to edema. 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. Onset of seven of the ten cases could be pinpointed almost. Summary although paraneoplastic rheumatic syndromes are rare, clinicians should be aware that they can be the first sign. Clinical features of rheumatoid arthritis medicine.
Its relapse is extremely rare in the benign forms and, when present, it presents only after several months 5. Background remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome is an acute inflammatory polyartritis and palpable pitting edema of the elderly patients. Rs3pe is an acute onset polyarthritis syndrome which can occur idiopathically or. It was formerly considered as a subset of rheumatoid arthritis ra, but is now regarded as a distinct diseasesyndrome. Myelodysplastic syndrome mds is characterized by infective hematopoiesis with possible transformation to leukemia. Clinical characteristics of patients with remitting. Europe pmc is a service of the europe pmc funders group, in partnership with the european bioinformatics institute. Rs3pe syndrome can be associated with both solid tumours like gastric, pancreatic and haematological malignancies like nonhodgkins lymphoma. Remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome was first reported by mccarty et al. Rs3pe syndrome is a rare rheumatological disorder of the. Myelodysplastic syndrome precedes the onset of remitting. The rs3pe syndrome remitting seronegative symmetrical synovitis with pitting edema is a manifestation of rheumatoid arthritis in the elderly with a good prognosis.
Most cases of remitting seronegative symmetrical synovitis with pitting edema syndrome are idiopathic, but some are secondary to malignancy, autoimmune disease, or neurodegenerative disorders. Rs3pe syndrome as a first manifestation of bladder. On anteriorposterior view of handwrist plain graphy, there were osteophyte. It is remitting seronegative symmetrical synovitis with pitting edema. The clinical features of the disease are characterized by bilateral pitting oedema of the hands and sudden onset of polyarthritis. Rs3pe syndrome remittive symmetrical seronegative synovitis with pitting edema was first described by maccarthy in 1985. Magnetic resonance imaging mri was used to describe the anatomical structures affected by inflammation in pure rs3pe syndrome. 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. Ra characteristically presents as a symmetrical polyarthritis, predominantly affecting the small joints. We report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema rs3pe associated with prostatic adenocarcinoma. In the latter, the clinical picture of rs3pe developed after surgical intervention for the primary lesion. Klippeltrenaunay syndrome and spinal arteriovenous. Syndrome of remitting seronegative symmetrical synovitis.
Polymyalgia rheumatica is a relatively common inflammatory rheumatic disease. 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. It usually presents as an acute, symmetric polysynovitis with edema of the dorsum of the hands and feet. Remitting seronegative symmetrical synovitis with pitting edema or sometimes rs3pe 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. Rs3pe syndrome is an inflammatory disease which affects mainly males and responds rapidly to lowdose steroids. All authors read and approved the final manuscript. The remitting seronegative symmetrical synovitis with pitting edema rs3pe syndrome was described by mccarty et al. Kts is a rare limb overgrowth disorder with slowflow vascular anomalies. The most common shorthand of remitting seronegative symmetrical synovitis with pitting edema is rs3pe.
It was acute in onset, severe in intensity to such an extent that she was unable to make a. Jul 31, 2017 polymyalgia rheumatica is an inflammatory disease that affects the shoulder, the pelvic girdles, and the neck, usually in individuals older than 50 years. It responds to low dose steroids and its prognosis is usually favorable. The rs3pe syndrome remitting seronegative symmetrical synovitis with pitting edema is a manifestation of rheumatoid. Both are syndromes of unknown cause, but genetic and environmental factors might have a role in their pathogenesis. Aug 29, 2008 remitting seronegative symmetrical synovitis with pitting oedema syndrome, a rare inflammatory arthritis, commonly affects people in the older age group. Out of these cookies, the cookies that are categorized as necessary are stored in your browser as they are essential for the working of basic functionalities of the website. Antiinflammatory treatment with corticosteroids leads to prompt improvement. Syndrome of remitting seronegative symmetrical synovitis with.
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