Palindromic rheumatism: Effect of dietary manipulation

Objective Evaluation of the contribution of dietary components in triggering the atta cks of palindromic rheumatism (PR), and the effect of dietary manipulation on the frequency and severity of PR attacks. Methods Sixteen patients (10 males, 6 females) were diagnosed as having PR during 1 994-8 in one center Their mean age was 45 +/- 6 duration of symptoms prior to diagnosis was 4 +/- 1.4 years, and frequency of PR attacks were 3.1 +/- 1.8/month. All patients were instructed to make a list of the food that was consumed daily and to specify the dates of PR episodes. Data were evaluate d after a period of 2-4 months in each patient. Results In 5 patients (31%) there was an association between episodes of PR and cer tain foods that were consumed within 36 hours prior to PR episodes. These w ere fish (2 patients), eggs, canned vegetables and processed cheese (each i n one case). Elimination of the relevant food from each patient's diet resu lted in complete cessation of the PIP attacks in two of the cases, while th e other three had milder; infrequent attacks. Four patients were rechalleng ed with the offending food. In all cases if resulted in recurrence of the P R attacks. No association between PR episodes and prior consumption of cert ain foods could be documented in the other 11 patients. Conclusion In some PR patients ingestion of certain foods, specific for each case, can trigger the typical attack. It is suggested that this association should b e looked for in any PR patient, as elimination of the offending food from t he diet may help in preventing the PR attacks.