J Korean Med Sci.  2003 Aug;18(4):606-608. 10.3346/jkms.2003.18.4.606.

Sjogren's Syndrome Presenting as Remitting Seronegative Symmetric Synovitis with Pitting Edema(RS3PE)

• Choi YM
• Sheen DH
• Lee YJ
• Lee EB
• Song YW

• KMID: 648919
• DOI: http://doi.org/10.3346/jkms.2003.18.4.606

Abstract

Remitting seronegative symmetric synovitis with pitting edema (RS3 PE) syndrome is characterized by symmetrical and acute synovitis, pitting edema, the absence of rheumatoid factor, increased acute phase reactants, lack of bony erosions on radiography, and benign and short clinical course. Half of all patients with Sjogren's syndrome experience arthritis during the disease course. We here describe the first case of Sjogren's syndrome presenting as RS3PE. She had swelling in knees, ankles, and wrists. After then the swelling spread to her lower legs, feet, face, and both hands. She was admitted to another hospital and was suspected of lupus or rheumatoid arthritis. Three months later, she had dry mouth and had lower lip biopsy. She was admitted to this hospital due to development of swelling in face and lower legs for 3 days. On physical examination, she had pitting edema in both hands and feet dorsum. Laboratory test showed elevated erythrocyte sedimentation rate, positivity of rheumatoid factor, anti-nuclear antibody, and anti-Ro antibody. There was no erosion in the hands radiography. Schirmer's test and lip biopsy was compatible with Sjogren's syndrome. She was diagnosed RS3 PE and Sjogren's syndrome. She was begun with prednisolone and her symptoms improved gradually.

Keyword

Sjogren's Syndrome; Synovitis; Edema; RS3PE

MeSH Terms

Adult
Antibodies, Antinuclear/biosynthesis
Arthritis/complications
Biopsy
Blood Sedimentation
Diagnosis, Differential
Edema/*diagnosis
Female
Human
Lymphocytes/pathology
Prednisolone/therapeutic use
Rheumatoid Factor/biosynthesis
Salivary Glands/pathology
Sjogren's Syndrome/*diagnosis
Syndrome
Synovitis/*diagnosis