Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital, Leeds, UK.
Nat Rev Rheumatol. 2019 Nov;15(11):687-695. doi: 10.1038/s41584-019-0308-5. Epub 2019 Oct 8.
Palindromic rheumatism is a distinctive syndrome that has a long-recognized association with rheumatoid arthritis (RA). Palindromic rheumatism is characterized by intermittent flares of pain, erythema and swelling in and around the joints, which are typically severe and unpredictable. The observation that most patients with palindromic rheumatism have RA-related autoantibodies and that many eventually develop RA has led to palindromic rheumatism often being viewed as a relapsing-remitting variant of RA. However, the clinical and imaging phenotypes of palindromic rheumatism suggest important distinctions from RA and imply underlying mechanistic differences between the two conditions. Furthermore, the pattern of inflammation seen in palindromic rheumatism has interesting parallels with that seen in other groups of symptomatic individuals at risk of developing RA. In this Review, we explore the concept of palindromic rheumatism as part of the RA continuum and propose an updated disease paradigm for this unique syndrome.
回纹性风湿病是一种独特的综合征，其与类风湿关节炎（rheumatoid arthritis，RA）有长期公认的关联。回纹性风湿病的特征是关节及其周围出现间歇性疼痛、红斑和肿胀，这些症状通常严重且不可预测。观察到大多数回纹性风湿病患者具有与 RA 相关的自身抗体，并且许多患者最终会发展为 RA，这导致回纹性风湿病通常被视为 RA 的复发性缓解变体。然而，回纹性风湿病的临床和影像学表型表明与 RA 存在重要区别，并暗示这两种疾病之间存在潜在的机制差异。此外，回纹性风湿病中观察到的炎症模式与其他有发展为 RA 风险的症状性个体群体中观察到的模式具有有趣的相似性。在这篇综述中，我们探讨了将回纹性风湿病视为 RA 连续体的一部分的概念，并为这一独特综合征提出了一个更新的疾病范例。
