Seminars in Arthritis and Rheumatism
Volume 40, Issue 1 , Pages 89-94, August 2010

Is Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) a Subset of Rheumatoid Arthritis?

  • Qingping Yao, MD

      Affiliations

    • Rheumatology Fellow, Division of Rheumatology and Immunology, Department of Medicine, David Geffen Medical School at UCLA, Los Angeles, CA
    • ,
  • Xiangqian Su, MD

      Affiliations

    • Visiting Scholar, Molecular and Medical Pharmacology, Jonsson Comprehensive Cancer Center, David Geffen Medical School at UCLA, Los Angeles, CA
    • ,
  • Roy D. Altman, MD

      Affiliations

    • Professor of Medicine, Division of Rheumatology and Immunology, Department of Medicine, David Geffen Medical School at UCLA, Los Angeles, CA
    • Corresponding Author InformationAddress reprint requests to Roy D. Altman, MD, Division of Rheumatology, UCLA, 1000 Veterans Ave., Rehab 39-52, Los Angeles, CA 90095

published online 17 February 2009.

Objectives

To contrast and compare the spectrum of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) with rheumatoid arthritis (RA) using an illustrative case.

Methods

The relevant English literature of RS3PE was searched using the keywords “RS3PE” alone and in combination with terms such as neoplasia and rheumatic disease. Original and review articles were reviewed and the clinical setting was exemplified with a case report.

Results

RS3PE initially was reported to represent a form of RA. However, RS3PE has clinical features that are different from both early- and late-onset RA, such as lack of bony erosions and rheumatoid factor. RS3PE is thought to involve vascular endothelial growth factor, suggesting an infectious etiology, generally has an excellent prognosis, and is associated with neoplasia not commonly seen in RA, and the RA associated human leukocyte antigen (HLA) DRB1 genotype is absent.

Conclusions

Based on the clinical, laboratory, suspected infectious etiology, genetic differences, and types of associated malignancies, RS3PE appears to be a distinct entity rather than a subset of RA.

Keywords: RS3PE, neoplasia, rheumatoid arthritis, infection and rheumatic disease, paraneoplastic syndromes, vascular endothelial growth factor

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 The authors have no conflicts of interest to disclose.

PII: S0049-0172(08)00214-X

doi:10.1016/j.semarthrit.2008.11.006

Seminars in Arthritis and Rheumatism
Volume 40, Issue 1 , Pages 89-94, August 2010

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