Nine cases of remitting seronegative symmetrical synovitis with pitting edema syndrome complicated with malignancies

Abstract

Objectives : We investigated the characteristics of RS3PE syndrome with malignancies, and investigated a relationship between RS3PE syndrome and malignancies.
Methods : A retrospective multicenter study of patients with RS3PE syndrome between October, 2003 and September, 2010, fulfilling the following criteria : (1)bilateral pitting edema of hands or feet, or both, (2) sudden onset of polyarthritis, (3) age ＞50 years, (4) seronegativity for rheumatoid factor (RF) was performed. Serum MMP-3 concentrations were examined byenzyme-linked immunosorbent assay (ELISA).
Results: A total of 9 cases fulfilled the above criteria for RS3PE syndrome. The serum CRP level was 10.8 mg/dl and the serum MMP-3 level was 437.3 ng/ml (median). All patients had a good response to corticosteroids. There were 7 male patients and 2 female patients, and they were complicated with gastric cancers, colon cancers, breast cancers, pulmonary cancers and prostatic cancer. In eight patients, malignant tumors were complicated within 2 years from onset of RS3PE syndrome. Three patients were complicated with malignancies one month before onset of RS3Pe syndrome and 3 patients within one month from onset of RS3PE syndrome. In these patients, serum MMP-3 levels were markedly elevated.
Discussions: We found that serum MMP-3 concentrations were very high in patients with RS3PE syndrome complicated with solid tumors.