REMITTING SERONEGATIVE SYMMETRICAL SYNOVITIS WITH PITTING EDEMA - DISEASE OR SYNDROME

Objective-To evaluate the outcome of patients with remitting seronegat ive symmetrical synovitis with pitting oedema (RS(3) PE). Methods-In a retrospective chart review study, we identified all the patients pres enting with polyarthritis and pitting oedema in the past 20 years. We tried to recall the 24 patients with characteristics of RS(3) PE accor ding to McCarty et al. Two patients had died and four could not be tra ced. Five could not be seen after the initial period of follow up; rel evant data were obtained from their practitioner. For the remaining 13 patients, clinical, radiological, and biological evaluation was perfo rmed in our department, with the last assessment in 1993. Results-The follow up period was from one to 18 years (mean 4.6 (SD 4.5) years). E leven patients developed one or several recurrences of articular manif estations consisting of mild oligoarthritis (n = 8), definite spondylo arthropathy (n = 2), and rheumatoid arthritis (n = 1). The delay of th e first recurrence was 18 months to 12 years after the first attack. T hirteen patients had no recurrence, but three of them developed remark able features: rheumatoid factor, antinuclear antibodies (1/2000), Sjo gren's syndrome. HLA B typing was performed in nine patients and revea led B7 (n = 2), B27 (n = 2) and B22 (n = 2). Isolated HLA B27 typing w as performed in two other patients and was positive in one. Conclusion -The long term outcome of RS(3) PE can lead to different rheumatic dis eases. RS(3) PE appears to be a syndrome related to the elderly onset of the rheumatic diseases, including spondyloarthropathy and rheumatoi d arthritis, rather than a specific entity.