Magy N, Michel F, Auge B, Toussirot E, Wendling D
Service de rhumatologie, h pital Jean-Minjoz, CHU, Besançon, France.
Joint Bone Spine. 2000;67(5):475-7.
Amyloid arthropathy is a form of primary AL amyloidosis with a monoclonal component in the blood and/or urine, and RS3PE syndrome is acute edematous polysynovitis in subjects older than 60 years. A 74-year-old man was diagnosed with both disorders. He was admitted for benign acute polyarthritis of the hands and feet and reported carpal tunnel symptoms predominating on the right. A synovial biopsy at the right wrist disclosed deposits that stained with Congo red even after potassium permanganate treatment (positive Wright's test). Articular AL amyloidosis was diagnosed. The symptoms resolved under glucocorticoid therapy alone, casting some doubt on their relationship with the amyloidosis. Roentgenograms showed geodes, a feature not present in RS3PE. Whether RS3PE may be among the possible presentations of articular amyloidosis is discussed.
淀粉样关节病是原发性AL淀粉样变性的一种形式，血液和/或尿液中有单克隆成分，而RS3PE综合征是60岁以上患者的急性水肿性多滑膜炎。一名74岁男性被诊断患有这两种疾病。他因手足良性急性多关节炎入院，报告称右侧腕管症状为主。右侧腕关节滑膜活检显示，即使经过高锰酸钾处理，沉积物刚果红染色仍呈阳性（Wright试验阳性）。诊断为关节型AL淀粉样变性。症状仅在糖皮质激素治疗下得到缓解，这对它们与淀粉样变性的关系提出了一些疑问。X线片显示有骨内囊肿，这是RS3PE中不存在的特征。本文讨论了RS3PE是否可能是关节型淀粉样变性的可能表现之一。
