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Characteristics and survival of 26 patients with paraneoplastic arthritis
  1. J Morel (j-morel{at}chu-montpellier.fr)
  1. I University and Lapeyronie teaching hospital, France
    1. V Deschamps
    1. I University and Lapeyronie teaching hospital, France
      1. E Toussirot
      1. CHU Hôpital Minjoz, France
        1. E Pertuiset
        1. René Dubos Hospital, France
          1. C Sordet
          1. CHU Hautepierre, Faroe Islands
            1. P Kieffer
            1. Altkirch Hospital, France
              1. J-M Berthelot
              1. CHU Nantes, France
                1. H Champagne
                1. Manchester Hospital, France
                  1. X Mariette
                  1. CHU Bicêtre, France
                    1. B Combe
                    1. Montpellier I University and CHU Lapeyronie, France

                      Abstract

                      Objective: At present only few series of patients with paraneoplastic arthritis have been published. Patientsf 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
                      • survival

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