缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征的临床分析

Clinical analysis on the syndrome of remitting seronegative symmetrical synovitis with pitting edema

目的了解缓和性血清阴性对称性滑膜炎伴凹陷性水肿综合征的临床和实验室特点。方法回顾性分析7例RS3PE综合征患者的临床资料。结果 7例患者中男5例,女2例,年龄45-69岁,平均61岁。均表现为突发双手、足背凹陷性水肿及多关节炎。血沉平均85mm/h,C反应蛋白平均65.9mg/L。3例患者手足关节X线表现为骨质疏松、关节间隙变窄。小剂量醋酸泼尼松和慢作用抗风湿药物治疗后临床症状缓解,1例3个月后合并过敏性紫癜。结论 RS3PE综合征是异质性临床症候群,小剂量醋酸泼尼松和慢作用抗风湿药物治疗有效,但该病与风湿性、肿瘤性、感染性疾病密切相关,积极治疗合并症可减少复发。

Objective To study remtting seronegative symmetrical synovitis with pitting edema（RS3PE） syndrome and laboratory features.Methods Clinical data of seven cases with RS3PE syndrome were retrospectively analyzed,including symptoms,signs,laboratory tests and therapeutic effect and prognosis.Results 7 patients（5 males and 2 females） aged 45 to 69 years old.The symptoms were the sudden hand,dorsal pitting edema and multiple arthritis,proximal interphalangeal and metacarpophalangeal arthritis,arthritis in five cases,two cases with wrist arthritis,arthritis in 4 cases of metatarsophalangeal feet,ankle arthritis 1 case.The average ESR was 85mm / h,average C-reactive protein was 65.9mm / L,rheumatoid factor,antinuclear antibody extract（anti-ENA antibodies） and DNA antibodies（ds-DNA antibodies）,human leukocyte antigen B27 were negative.X-ray of hand,foot and joint findings in three patients with osteoporosis,joint space narrowing.Small dose of prednisone acetate and slow-acting antirheumatic drug therapy the clinical symptoms,concurrent infection by anti-infection treatment had no recurrence,1 case 3 months after the merger of allergic purpura.Conclusion RS3PE syndrome is a heterogeneous syndrome,small doses of prednisone acetate and slow-acting antirheumatic drug treatment is effective,but disease and rheumatic,neoplastic,infectious diseases are closely related,active treatment can reduce complications and recurrence.