SEMRA AKTÜRK

Syndrome of Remitting Seronegative Symmetrical Synovitiswith Pitting Edema (RS3PE): A Case Report and Review of the Literature

Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) is a rare clinical entity that is easily missed due to lack of knowledge. Syndrome is characterized by sudden onset of edema with swelling on the dorsum of the hands and by synovitis. Serological tests are negative and radiographic joint destruction does not occurs. Etiology of RS3PE syndrome is not known. It can occur as an idiopathic phenomenon, but also is in association with rheumatic diseases. In addition, several reports have described RS3PE as a paraneoplastic syndrome can occur on concomitantly with both hematological and solid malignancies. Because of this clinical association, it is not very easy to diagnose this syndrome. We discuss a case of RS3PE where the patient presented with acute onset polyarthritis and pitting edema of the extremities without an underlying systemic cause. Patient showed dramatic response with low dose steroid therapy

PDF

___

1. McCarty DJ, O’Duffy JD, Pearson L, Hunter JB. Remitting sero negative symmetrical synovitis with pitting edema. RS3PE syndrome. JAMA. 1985;254(19):2763-7.

2. Olivieri I, Salvarani C, Cantini F. RS3PE syndrome: an overview. Clin Exp Rheumatol. 2000;18(4 Suppl 20):S53-5.

3. Russell EB. Remitting seronegative symmetrical synovitis with pitting edema syndrome: follow up for neoplasia. J Rheumatol. 2005;32(9):1760-1.

4. Ferrao C, Faria RM, Farrajota P, Vasconcelos C. Lucky to meet RS3PE. BMJ Case Rep. 2013;2013.

5. Olive A, del Blanco J, Pons M, Vaquero M, Tena X. The clinical spectrum of remitting seronegative symmetrical synovitis with pitting edema. J Rheumatol. 1997;24(2):333-6.

6. Medrano San Ildefonso M, Mauri Llerda JA. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE): a para neoplastic syndrome? A new case. Clin Exp Rheumatol. 2007;25(2):342.

7. Queiro R, Alperi M, Riestra JL, Ballina J. RS3PE syndrome: bad or good prognosis? J Rheumatol 2007;34(2):452-3.

8. Sekhon L. Remitting seronegative symmetrical synovitis with pitting edema. JAAPA. 2010;23(2):38,40,43.

9. Marto G, Klitna Z, Bileu MC, Barcelos A. Remitting seronegative symmetrical synovitis with pitting edema syndrome, associated with prostate adenocarcinoma: a case report. Acta Reumatol Port. 2010;35(3):358-60.

10. Varshney AN, Kumar N, Tiwari A, Anand R, Prasad SR, Anand A, Mishra A, Singh NK. Unilateral RS3PE in a patient of sero negative Rheumatoid Arthritis. Case Rep Rheumatol. 2013;2013:923797.

11. Ozşahin M, Ataoğlu S, Turan H. Unilateral RS3PE with young-onset rheumatoid arthritis. Semin Arthritis Rheum. 2011;40(4):e1.

12. Oide T, Ohara S, Oguchi K, Maruyama M, Yazawa M, Inoue K, Sekijima Y, Tokuda T, Ikeda S. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in Nagano, Japan: clinical, radiological, and cytokine studies of 13 patients. Clin Exp Rheumatol. 2004;22(1):91-8.

13. Şendur OF, Ozer H, Tureli C. RS3PE: Bir olgu sunumu. Turk Fiz Tıp Rehab Derg. 1999;3:8-16.

14. Roblot P, Zaim A, Azais I, Ramassamy A, Paccalin M, Becq-Giraudon B. RS3PE: a clinical diagnosis, a prognosis more simple than its name. Rev Med Interne. 1998;19(8):542-7.