Comparing the Clinical and Laboratory Features of Remitting Seronegative Symmetrical Synovitis with Pitting Edema and Seronegative Rheumatoid Arthritis: Stage 1

Misako Higashida-Konishi,Yutaka Okano,Hiroshi Takei,Satoshi Hama,Keisuke Izumi,Hisaji Oshima

doi:10.3390/jcm10020340

Misako Higashida-Konishi, Yutaka Okano + Show 4 more

Open Access

https://doi.org/10.3390/jcm10020340

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Abstract

In seronegative arthritis with extremity edema, the differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (SNRA) is difficult. We compared the clinical characteristics of RS3PE and SNRA and those of such patients with and without malignancies. We retrospectively examined patients diagnosed with RS3PE (McCarty criteria) and SNRA at our hospital in 2007–2020. Malignancy was diagnosed within 2 years before or after RS3PE or SNRA diagnosis. Overall, 24 RS3PE and 124 SNRA patients were enrolled. The mean ages were 79.0 and 66.5 years, and men comprised 54.2% and 37.1% of RS3PE and SNRA patients, respectively. RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p < 0.01). Matching for age and sex, RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p = 0.02). Overall, odds ratios (ORs) for malignancy were higher for older age (OR 1.06, p = 0.04), male sex (OR 4.34, p = 0.02), RS3PE patients (OR 4.83, p = 0.01), and patients with extremity edema (OR 4.83, p = 0.01). RS3PE patients had higher inflammation levels and associated factors of malignancy than SNRA patients. Patients who are older, male, with extremity edema, or with RS3PE should be screened for malignancies.

Highlights

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) was first reported by McCarty et al in 1985 [1]. It is characterized by pitting edema of the extremities, sudden onset of polyarthritis, seronegativity for rheumatoid factor (RF), excellent response to glucocorticoids, and the absence of radiologically evident erosions [1]
polymyalgia rheumatica (PMR) and RS3PE were included in the RS3PE group and those who met the criteria for both PMR and seronegative rheumatoid arthritis (RA) were included in the seronegative RA group
For patients diagnosed with PMR before 2012, we retrospectively reviewed whether they met the 2012 PMR classification criteria

Summary

Introduction

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) was first reported by McCarty et al in 1985 [1]. It is characterized by pitting edema of the extremities, sudden onset of polyarthritis, seronegativity for rheumatoid factor (RF), excellent response to glucocorticoids, and the absence of radiologically evident erosions [1]. The primary aim of this study was to compare the clinical characteristics of RS3PE and seronegative RA and evaluate the frequency of concurrent malignancy. The secondary aim was to compare the clinical features with and without malignancies in patients with. RS3PE and to compare the clinical features with and without malignancies in patients with seronegative RA

Patients

RS3PE Diagnosis

Seronegative RA Diagnosis

Clinical and Laboratory Features

Findings

Statistical Analysis