Abid Alina, Nawaz Umer, Sunmboye Kehinde O
Internal Medicine, University Hospitals of Leicester National Health Service Trust, Leicester, GBR.
Internal Medicine, National Health Service England Education East Midlands, Leicester, GBR.
Cureus. 2024 Oct 9;16(10):e71153. doi: 10.7759/cureus.71153. eCollection 2024 Oct.
Paraneoplastic rheumatologic syndromes encompass a range of clinical conditions that mimic primary rheumatic diseases and occur in the context of malignancy. Hypertrophic osteoarthropathy (HOA) is a notable example of such a syndrome, which is frequently associated with intrathoracic malignancies, including primary lung tumors and metastases. This report presents a case of a patient diagnosed with HOA secondary to lung adenocarcinoma, who was admitted with symmetric polyarthritis that resembled elderly-onset rheumatoid arthritis. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are primarily associated with rheumatoid arthritis, but their levels can be falsely elevated in various other conditions. In clinical practice, it's essential to interpret anti-CCP antibody results in conjunction with other clinical findings and laboratory tests to arrive at an accurate diagnosis. This case underscores the importance of considering HOA in the differential diagnosis of inflammatory arthritis, particularly in patients with a known or suspected malignancy, especially in the presence of positive rheumatoid arthritis-specific antibodies. Also, recognition and treatment of the underlying condition can lead to substantial improvements in both rheumatologic and oncologic aspects.
副肿瘤性风湿综合征包括一系列模仿原发性风湿疾病且发生于恶性肿瘤背景下的临床病症。肥大性骨关节病(HOA)就是这类综合征的一个显著例子,它常与胸内恶性肿瘤相关,包括原发性肺肿瘤和转移瘤。本报告介绍了一例被诊断为继发于肺腺癌的HOA患者,该患者因类似老年发病类风湿关节炎的对称性多关节炎入院。抗环瓜氨酸肽(anti-CCP)抗体主要与类风湿关节炎相关,但其水平在其他各种情况下可能会出现假升高。在临床实践中,结合其他临床发现和实验室检查来解读抗CCP抗体结果对于准确诊断至关重要。该病例强调了在炎症性关节炎的鉴别诊断中考虑HOA的重要性,特别是在已知或疑似患有恶性肿瘤的患者中,尤其是在类风湿关节炎特异性抗体呈阳性的情况下。此外,识别和治疗潜在疾病可在风湿和肿瘤方面带来显著改善。