Abstract:
BACKGROUND:The RS3PE syndrome is a recently described uncommon disorder in the elderly patient; in the initial reports, it was characterized by an excellent prognosis with total remission. In contrast with rheumatoid arthritis and polymyalgia rheumatic, it has been related to HLA B7. Further works have questioned its benign nature and even that it is a new entity. Our objective was to study the clinico-biological characteristics, therapy, and clinical course in patients with RS3PE attended at our clinic. METHODS:Retrospective descriptional study of patients with RS3PE attended in our clinic from January 1992 to December 1998 following the inclusion criteria proposed by Olivé et al. For all patients, the following determinations and studies were performed: complete blood count, ESR, serum biochemistry, two measurements of rheumatoid factor (RF), and X-ray. Class I HLA typing was determined in five cases. RESULTS:Eight patients were found (6 men and 2 women), with a mean age of 68.7 years. The arthritis was more common at MCP, wrists, shoulder, and PIF in hands. Four patients had tenosynovitis of the hand flexors. ESR (mean: 69.3) and RCP (mean: 49.7) were increased in most cases. Seven patients had leukocytosis. HLA B7 was positive for 4 out of five patients. All patients were treated with low-dose corticosteroids, with a mean length of 9.5 months. Three patients had relapses. During follow-up after therapy had been completed, none of the patients had other diseases. CONCLUSIONS:RS3PE syndrome involves elderly patients and its clinical course is characterized by sudden onset seronegative symmetrical polysynovitis, with pitting edema over the hand dorsum and less commonly over the pretibial region. In most cases, a marked acute-phase reaction and leukocytosis were observed. Therapy with low-dose corticosteroids is effective; sometimes however, it is necessary to add antimalarial agents. The three patients who relapsed had underlying diseases: chronic lymphocytic leukemia, Sjögren's syndrome, and liver cirrhosis, respectively. The diagnosis of RS3PE should be obtained a posteriori, after a prolonged follow-up of the patient. Atypical cases, with evolution towards other rheumatic or hematological disorders or as paraneoplastic manifestation, have been reported.
journal_name
Rev Clin Espjournal_title
Revista clinica espanolaauthors
Cobeta García JC,Martínez Burgui Jkeywords:
subject
Has Abstractpub_date
1999-12-01 00:00:00pages
785-9issue
12eissn
0014-2565issn
1578-1860journal_volume
199pub_type
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
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journal_title:Revista clinica espanola
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journal_title:Revista clinica espanola
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更新日期:1993-12-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
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journal_title:Revista clinica espanola
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journal_title:Revista clinica espanola
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journal_title:Revista clinica espanola
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doi:
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journal_title:Revista clinica espanola
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journal_title:Revista clinica espanola
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journal_title:Revista clinica espanola
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doi:
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:10.1157/13072969
更新日期:2005-03-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
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doi:10.1016/s0014-2565(09)71240-8
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:10.1016/s0014-2565(02)71136-3
更新日期:2002-10-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:10.1157/13128673
更新日期:2008-11-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
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journal_title:Revista clinica espanola
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00