Skin in rheumatoid arthritis and seronegative arthritis

Whipple’s disease (WD) is an uncommon cause of seronegative arthritis. WD is known for its gastrointestinal symptoms of diarrhea, weight loss, and abdominal pain. However, arthritis may precede gastrointestinal symptoms by 6 to 7 years. We describe a case of an 85-year-old Caucasian male with multiple joint complaints, not responsive to traditional treatments for conditions such as rheumatoid arthritis and osteoarthritis. We suggest that WD be considered for seronegative arthritis especially affecting large joints.

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Disease-modifying antirheumatic drugs other than methotrexate in rheumatoid arthritis and seronegative arthritis

Current Opinion in Rheumatology ◽

10.1097/bor.0b013e3282fb7caa ◽

2008 ◽

Vol 20 (3) ◽

pp. 251-256 ◽

Cited By ~ 19

Author(s):

Pradip Nandi ◽

Gabrielle H Kingsley ◽

David L Scott

Keyword(s):

Rheumatoid Arthritis ◽

Seronegative Arthritis ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Disease Modifying

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

Journal of Clinical Medicine ◽

10.3390/jcm10020340 ◽

2021 ◽

Vol 10 (2) ◽

pp. 340

Author(s):

Misako Higashida-Konishi ◽

Keisuke Izumi ◽

Satoshi Hama ◽

Hiroshi Takei ◽

Hisaji Oshima ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Associated Factors ◽

Clinical Characteristics ◽

Seronegative Arthritis ◽

Laboratory Features ◽

The Mean ◽

Male Sex ◽

Stage 1 ◽

Pitting Edema ◽

Age And Sex

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.

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Chronic Myelomonocytic Leukemia Presenting With Polyserositis and Seropositivity for Rheumatoid Arthritis

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620966863 ◽

2020 ◽

Vol 8 ◽

pp. 232470962096686

Author(s):

Anthony Kunnumpurath ◽

Sai Prasad Desikan ◽

Charles McClain ◽

Raman Desikan

Keyword(s):

Rheumatoid Arthritis ◽

Retrospective Studies ◽

Systemic Vasculitis ◽

Connective Tissue Diseases ◽

Chronic Myelomonocytic Leukemia ◽

Seronegative Arthritis ◽

Positive Serology ◽

Course Of Illness ◽

Myelomonocytic Leukemia ◽

Cell Disorder

Chronic myelomonocytic leukemia (CMML) is a rare clonal stem cell disorder associated with clinical and pathologic of myelodysplasia and myeloproliferation. Systemic autoimmune/inflammatory disorders (SAID) and polyserositis have been associated with CMML. These manifestations can be observed concomitantly, shortly before diagnosis or anytime along the course of illness. We report a case of myeloproliferative CMML who presented with polyserositis and positive serology for rheumatoid arthritis. Retrospective studies of myelodysplasia/CMML have reported 15% to 25% incidence of SAID. The most commonly observed disorders include systemic vasculitis, connective tissue diseases, polychondritis, seronegative arthritis, and immune thrombocytopenia. SAID does not confer adverse prognosis in retrospective studies. Polyserositis is less common; this may result from leukemic infiltrate or result from autoimmunity. Treatment of serositis includes steroids and cytoreductive agents. Serositis may confer poor prognosis and hypomethylating therapy may improve the outcome.

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

Journal of Clinical Medicine ◽

10.3390/jcm10051116 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1116

Author(s):

Misako Higashida-Konishi ◽

Keisuke Izumi ◽

Satoshi Hama ◽

Hiroshi Takei ◽

Hisaji Oshima ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Associated Factors ◽

Clinical Characteristics ◽

Older Age ◽

Seronegative Arthritis ◽

Odds Ratios ◽

Laboratory Features ◽

Male Sex ◽

Pitting Edema ◽

Age And Sex

In seronegative arthritis with extremity edema, it is difficult to differentiate between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (SNRA). We compared the clinical characteristics of RS3PE and SNRA in 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 median ages were 79.5 and 68.5 years, and men comprised 54.2% and 37.1% of RS3PE and SNRA patients, respectively. RS3PE patients had higher inflammation levels (p = 0.004) and more incidences of malignancy (p = 0.034). Matching for age and sex, RS3PE patients had higher inflammation levels (p = 0.021) and more incidences of malignancy (p = 0.005). Overall, odds ratios (ORs) for malignancy were higher for older age (OR 1.06, p = 0.037), male sex (OR 4.34, p = 0.007), RS3PE patients (OR 4.83, p = 0.034), and patients with extremity edema (OR 4.83, p = 0.034). Inflammation levels and associated factors of malignancy were higher in RS3PE patients than in SNRA patients. Patients who are older, male, with extremity edema, or had RS3PE should be screened for malignancies.

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