Roblot P, Zaim A, Azais I, Ramassamy A, Paccalin M, Becq-Giraudon B
Service de médecine interne et maladies infectieuses, CHU La Milétrie, Poitiers, France.
Rev Med Interne. 1998 Aug;19(8):542-7. doi: 10.1016/s0248-8663(99)80021-6.
RS3PE syndrome (remittive symmetrical seronegative synovitis with pitting edema) was first described by MacCarthy in 1985. It is a rare type of seronegative polyarthritis occurring in the elderly.
Retrospective report of 13 cases (including eight male and five female patients; mean age 76.7 +/- 3.7 years) and search for previously reported cases, using the Medline database.
Pitting edema was present at onset of disease in nine cases. Joint arthritis was bilateral, occurring in the wrist (13 cases), shoulder (six cases), elbow (six cases), knee (six cases), ankle (four cases), metacarpophalangeal (four cases) and hip (one case). Radiographies were normal. Mean erythrocyte sedimentation rate was 62 +/- 19 mm at the first hour and mean C-reactive protein level was 73 +/- 35 mg/L. Mild cholestasis was present in four of the seven patients for whom data were available. HLA B7 was present in five out of 12 cases (42%). Improvement was favorable, occurring over 7 months. Mean follow-up was 22.2 months. Fifty-nine other cases have been described in the literature. This syndrome, which affects the elderly, appears to be rare. Its clinical presentation is quite constant, with sudden onset, symmetrical polyarthritis and pitting edema. Its evolution, often long, is favorable. Rheumatoid arthritis and polymyalgia rheumatica are the main differential diagnoses.
Due to its favorable outcome and the usefulness of a mild corticotherapy, this syndrome, though rare, should be diagnosed where necessary in elderly patients.
RS3PE综合征（缓解性对称性血清阴性滑膜炎伴凹陷性水肿）于1985年由麦卡锡首次描述。它是一种发生于老年人的罕见的血清阴性多关节炎类型。
对13例患者（包括8例男性和5例女性患者；平均年龄76.7±3.7岁）进行回顾性报告，并使用Medline数据库检索先前报道的病例。
9例患者在疾病发作时出现凹陷性水肿。关节关节炎为双侧性，累及腕关节（13例）、肩关节（6例）、肘关节（6例）、膝关节（6例）、踝关节（4例）、掌指关节（4例）和髋关节（1例）。X线检查正常。首小时平均红细胞沉降率为62±19mm，平均C反应蛋白水平为73±35mg/L。在有数据的7例患者中，4例出现轻度胆汁淤积。12例中有5例（42%）存在HLA B7。病情改善良好，在7个月内出现。平均随访时间为22.2个月。文献中还描述了其他59例病例。这种影响老年人的综合征似乎很罕见。其临床表现相当一致，起病突然，对称性多关节炎和凹陷性水肿。其病程通常较长，但预后良好。类风湿关节炎和风湿性多肌痛是主要的鉴别诊断。
由于其良好的预后以及轻度皮质类固醇治疗的有效性，这种综合征虽然罕见，但在老年患者必要时应予以诊断。
