Schmalzing Marc
Zentrum Innere Medizin, Medizinische Klinik und Poliklinik II, Rheumatologie/Klinische Immunologie, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
Z Rheumatol. 2018 May;77(4):309-321. doi: 10.1007/s00393-018-0445-2.
Rheumatic paraneoplastic syndromes are paraneoplastic arthritis, palmar fasciitis and polyarthritis syndrome, remitting seronegative symmetrical synovitis with pitting edema, pancreatic panniculitis with polyarthritis, paraneoplastic vasculitis, cancer-associated myositis, hypertrophic osteoarthropathy (Marie-Bamberger disease) and tumor-induced osteomalacia. Typical clinical manifestations, pathogenesis, prognosis, and treatment of this entity are presented. Knowledge of these disease entities can lead to timely diagnosis of the underlying malignant disease and to a higher probability of a cure. Response of the paraneoplastic inflammatory manifestations to corticosteroids, non-steroidal anti-inflammatory drugs or immunosuppressants is often insufficient. Curative removal of the malignant disease is crucial for the course of the paraneoplastic syndrome. When a paraneoplastic etiology of rheumatic symptoms is suspected, a step-wise diagnostic strategy is advisable.
风湿性副肿瘤综合征包括副肿瘤性关节炎、掌腱膜挛缩症和多关节炎综合征、伴有凹陷性水肿的缓解型血清阴性对称性滑膜炎、伴有多关节炎的胰腺性脂膜炎、副肿瘤性血管炎、癌症相关性肌炎、肥大性骨关节病（Marie-Bamberger病）和肿瘤诱导的骨软化症。本文介绍了该疾病的典型临床表现、发病机制、预后及治疗方法。了解这些疾病实体有助于及时诊断潜在的恶性疾病，并提高治愈的可能性。副肿瘤性炎症表现对皮质类固醇、非甾体抗炎药或免疫抑制剂的反应往往不足。根治恶性疾病对于副肿瘤综合征的病程至关重要。当怀疑风湿症状有副肿瘤病因时，建议采用逐步诊断策略。
