Anti-citrullinated Protein Antibody-positive Rheumatoid Arthritis Associated with RS3PE Syndrome-like Symptoms and an Elevated Serum Vascular Endothelial Growth Factor Level in a Patient with Myasthenia Gravis

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A 73-year-old man with a history of myasthenia gravis (MG) was diagnosed with rheumatoid arthritis (RA) based on a history of polyarthritis and positivity for anti-citrullinated protein antibodies (ACPA). He presented with a high level of serum vascular endothelial growth factor (VEGF) and RS3PE syndrome-like pitting edema in the extremities, which improved following treatment with low-dose prednisolone. This is an interesting case of ACPA-positive RA associated with RS3PE syndrome-like pitting edema and a high VEGF level.