Paraneoplastic remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome): a report of two cases and review of the literature

Rheumatol Int. 2004 Jul;24(4):234-7. doi: 10.1007/s00296-003-0395-z. Epub 2003 Oct 31.

Abstract

We report two cases of paraneoplastic remitting seronegative symmetrical synovitis with pitting edema (RS3PE) associated with prostatic adenocarcinoma. One of the patients was positive for Helicobacter pylori and the other had secondary bone metastases. In the latter, the clinical picture of RS3PE developed after surgical intervention for the primary lesion. On physical examination, while the hands and feet were swollen in the first patient, pitting edema was present only at the feet of the other. All joints of the affected hands and feet were painful. Serological tests including rheumatoid factor, antinuclear antibody, and human leukocyte antigen B27 were all negative. Response to low-dose corticosteroid treatment was delayed in the first patient, but the symptoms were relieved better in the second one.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology*
  • Aged
  • Drug Therapy, Combination
  • Edema / drug therapy
  • Edema / pathology*
  • Helicobacter Infections / complications
  • Helicobacter Infections / pathology
  • Humans
  • Male
  • Methylprednisolone / therapeutic use
  • Paraneoplastic Syndromes / drug therapy
  • Paraneoplastic Syndromes / pathology*
  • Prostatic Neoplasms / pathology*
  • Serologic Tests
  • Syndrome
  • Synovitis / drug therapy
  • Synovitis / pathology*
  • Treatment Outcome

Substances

  • Methylprednisolone