Fibroblastic rheumatism. Report of one case.

Fibroblastic rheumatism is a rare entity. Nineteen cases were reported in t he literature, and among them, only one in a child. Case report. - Cam. (born August 19, 1988) had an onset of disease in Octob er 1996 with nodules on the MCP and PIP: elbows and tibia, with partial imp rovement after three months. In April 1997, she suffered from arthralgia an d stiffness of both wrists, and then of the big toes. X-rays showed destruc tive and erosive lesions on both wrists and on the PIP of the second and th ird fingers and the big foes. Laboratory investigations disclosed normal va lues for ESR and CRP and negative results for ANA and RF: The diagnosis of fibroblastic rheumatism was based on the typical histologic pattern of a no dule. The treatment associated colchicin and rehabilitation. In August 1998 , the wrists' stiffness began to improve, though the big toes remained tota lly stiff. The radiologic erosive lesions did not show progress. Comments. - The diagnosis of fibroblastic rheumatism is based on the histol ogic pattern of the nodules. The erosive evolution of the arthropathies is infrequent (8/15 cases in adults). Juvenile onset is very rare; only one ca se has been reported, in a 10-year-old boy. The mechanism of the disease re mains unknown. As it is very rare, the therapeutic strategies are not well established. Conclusion. - This disease should be considered among the causes of juvenil e arthritis with erosion. (C) 2001 Editions scientifiques et medicales Else vier SAS.