Joseph Anne Dd, Kumanan Thirunavukarasu, Aravinthan Naarani, Suganthan Navaneethakrishnan
University Medical Unit, Teaching Hospital, Jaffna, Sri Lanka.
Rheumatology Unit, Teaching Hospital, Jaffna, Sri Lanka.
SAGE Open Med Case Rep. 2020 Mar 18;8:2050313X20910920. doi: 10.1177/2050313X20910920. eCollection 2020.
Remitting seronegative symmetrical synovitis with pitting edema is a rare but well-recognized clinical entity that is easily overlooked due to lack of clinical vigilance. It is classically described as an acute onset of symmetrical tenosynovitis of both upper and lower extremities with pitting edema, mostly noted in elderly population. Young patients with other rheumatological diseases and unilateral involvement had also been reported, but symmetrical remitting seronegative symmetrical synovitis with pitting edema in a young patient is a rare observation. We hereby report a case of a remitting seronegative symmetrical synovitis with pitting edema in a young male affected by no rheumatological diseases in the past, typically fulfilling the diagnostic criteria and well responded to low-dose steroid therapy. The salient features of the present case in terms of age, remitting seronegative symmetrical synovitis with pitting edema possibly related to undifferentiated arthropathy, reactive arthritis, or diabetes mellitus.
伴有凹陷性水肿的缓解型血清阴性对称性滑膜炎是一种罕见但已得到充分认识的临床病症，由于缺乏临床警惕性，很容易被忽视。其典型表现为急性起病的上下肢对称性腱鞘炎并伴有凹陷性水肿，多见于老年人群。也有报道称年轻患者患有其他风湿性疾病且为单侧受累，但年轻患者出现伴有凹陷性水肿的缓解型血清阴性对称性滑膜炎则较为罕见。我们在此报告一例年轻男性患者，既往无风湿性疾病，患有伴有凹陷性水肿的缓解型血清阴性对称性滑膜炎，典型地符合诊断标准，且对低剂量类固醇治疗反应良好。就年龄而言，本病例的显著特征为伴有凹陷性水肿的缓解型血清阴性对称性滑膜炎，可能与未分化关节病、反应性关节炎或糖尿病有关。
