title: The clinical spectrum of remitting seronegative symmetrical synovitis with pitting edema. The Catalán Group for the Study of RS3PE.
abstract: OBJECTIVE
  To describe the clinical and laboratory features and outcome of patients with remitting seronegative symmetrical synovitis with pitting edema (RS3PE).
  
  
  METHODS
  A retrospective multicenter study of patients with RS3PE fulfilling the following criteria: (1) bilateral pitting edema of both hands, (2) sudden onset of polyarthritis, (3) age > 50 years, (4) seronegative for rheumatoid factor (RF).
  
  
  RESULTS
  27 patients with RS3PE were included, mean age 71.7 years (58-92), 18 men (66.6%) and 9 women (33.3%). Relevant history was noted in 2 patients with polymyalgia rheumatica. Main clinical features were polyarthritis and edema of both hands. Polyarthritis involved metacarpophalangeal joints in 22 patients (81.5%), proximal interphalangeal joints in 19 (70.4%), wrists in 15 (55.5%), shoulders in 13 (48%), elbows in 3 (11.1%), knees in 9 (33.3%), and ankles in 7 (25.9%). All patients were RF negative. Antinuclear antibodies were positive at low titer in 8 patients. Erosions were present in one patient. Two patients developed T lymphoma and one myelodysplastic syndrome.
  
  
  CONCLUSIONS
  RS3PE is a heterogeneous syndrome the clinical history, presence of erosions, and evolution to hematological diseases in our patients suggest that RS3PE may not be a distinct clinical entity.
authors.affiliation: Rheumatology Section, Hospital Universitari Germans Trias i Pujol, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Olivé
authors.forename: J
authors.initials: J
authors.lastname: del Blanco
authors.forename: M
authors.initials: M
authors.lastname: Pons
authors.forename: M
authors.initials: M
authors.lastname: Vaquero
authors.forename: X
authors.initials: X
authors.lastname: Tena
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000276:immunology; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D004487:Edema / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007592:Joint Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012217:Rheumatoid Factor / Q000032:analysis; D013577:Syndrome; D013585:Synovitis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D000305:Adrenal Cortex Hormones; D012217:Rheumatoid Factor