Abstract
Among elderly patients with seronegative polyarthritis, McCarty et al. proposed the disease entity of “Remitting Seronegative Symmetrical Synovitis with Pitting Edema(RS3PE) syndrome” in 1985; however, few cases have been reported involving hemodialysis patients. Here, we report a patient with suspected RS3PE syndrome who underwent hemodialysis. The patient was a 71-year-old woman who had been on maintenance dialysis since 2004. She fractured the metatarsal of the fifth left toe in January 2009, and underwent hospitalization for surgery. The surgery went well; however, she had an attack of fever in the middle of February. Following a workup, she was suspected of having RS3PE syndrome. On starting steroid treatment, her limb edema and arthritic pain improved. In the subsequent course of treatment, it was doubtful whether this syndrome could involve a type of paraneoplastic edema and polyarthritis. When elderly hemodialysis patients develop symmetrical limb pitting edema with a relatively acute onset, RS3PE syndrome should be considered as a part of the differential diagnosis.
