In 1985, McCarty and colleagues reported a series of patients characterised by symmetrical and acute synovitis, marked pitting oedema, seronegativity resulting from the absence of rheumatoid factors (RF), increased acute phased reactants, lack of bony erosions on radiography, and benign and short course (RS3PE syndrome: remitting seronegative symmetrical synovitis with pitting oedema).1Most patients were older men. A pitting oedema was also observed in other conditions (polymyalgia rheumatica (PMR) and late onset peripheral spondylarthropathy (LOPS)).2 ,3 Whether the RS3PE syndrome represents a distinct clinical entity remains controversial.

This syndrome was initially reported to be associated with HLA-B (B7) rather than HLA-DR (DR4) antigens.1 ,4Recently, an association with HLA-A2 was reported.5 The association between RA and HLA-DRB1* alleles expressing the shared epitope (SE) (*0401, *0404, *0405, *0408, *0101, *0102, *1001, *1402) is well established. Older age onset RA and seronegative RA are known to be poorly or slightly related to DR4.6 ,7 Futhermore, an association was reported between the HLA-DR antigens that contain the …