Objective: At present only few series of patients with paraneoplastic arthritis have been published. Patientsf charts with cancer associated arthritis were collected in order to describe characteristics of this rheumatism.
Methods: A questionnaire was made up for this study and validated by experts based on specific criteria of inclusion and exclusion. Histology of neoplasia was required to be included.
Results: 16 males and 10 females with a mean age of 57.5 years (28-85) were recruited from seventeen nationwide centres. Patients presented with symmetric polyarthritis involving wrists and hands (85%) and extra-articular symptoms were frequent (84%). There was no specific biologic or radiographic feature. The mean delay between the diagnosis of rheumatism and neoplasia was 3.6 months (0-21.2). Tumors were usually diagnosed after articular symptoms occurred (88.5%). Twenty patients had a solid cancer and 6 a hematological malignancy. Adenocarcinoma of the lungs was the most frequent type of solid cancer (60%). Tumors were diagnosed at an early stage, which may explain the good median survival of 1.21 years (0.64 - ∞) with a mean follow-up of 1.9 years (0.16-10). The percentage of articular symptoms resolution was significantly higher in patients with solid tumors, as compared to patients with hemopathy (p=0.007). In cases tumor relapsed, rheumatic symptoms did not reoccur for 75% of patients.
Conclusions: Underlying neoplasia should be considered in male patients with new onset polyarthritis, smokers, and particularly in patients chronically ill. Then, additional investigations should be performed to diagnose a cancer at an early stage.
- haematological malignancies
- paraneoplastic arthritis
- solid tumors