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