title: Anticyclic citrullinated peptide antibody-positive paraneoplastic polyarthritis in a patient with metastatic pancreatic cancer.
abstract: Neoplasms may present as rheumatic disorders. Some of these rheumatologic manifestations may be paraneoplastic and can clinically and serologically mimic rheumatoid arthritis (RA). We report the case of a patient who initially presented with an asymmetrical, rapid onset polyarthritis. It resembled atypical RA with positive rheumatoid factor and anticyclic citrullinated peptide (CCP) antibodies. A good response to steroid therapy was noted. A few weeks later, he was diagnosed with metastatic pancreatic cancer that resulted in his mortality. His clinical course suggested that his rheumatic symptoms were a paraneoplastic manifestation of his underlying malignancy. Anticyclic citrullinated peptide antibodies have not been previously described in cancer polyarthritis. Awareness of this atypical, seropositive RA-like syndrome may prompt clinicians to investigate for an underlying malignancy.
authors.affiliation: Department of Internal Medicine, Wayne State University/Detroit Medical Center, University Health Center, Detroit, Michigan, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Kumar
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sethi
authors.forename: Farzan
authors.initials: F
authors.lastname: Irani
authors.forename: Barbara Y
authors.initials: BY
authors.lastname: Bode
mesh_terms: D001168:Arthritis / Q000209:etiology* / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000556:secondary; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000276:immunology*; D010456:Peptides, Cyclic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide