RS3PE presenting in a unilateral pattern: Case report and review of the literature
Keenan RT et al. – Although remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is almost always a symmetric disease of the upper extremities, it may rarely present in a unilateral fashion, suggesting a role for neural and possibly other local factors in the genesis/modulation of the onset or maintenance of the disease. Methods- Study to review the clinical features and pathophysiologic implications of RS3PE presenting in a unilateral manner
- An index case of unilateral RS3PE was identified and characterized
- A systematic literature search to identify other reports of pts
Results- Index case: 76-yr-old male, cerebrovascular accident 25 yrs prior, developed a classic picture of RS3PE accompanied by an elevated ESR, but only in the nonhemiparetic hand
- Condition responded rapidly to low-dose prednisone
- Literature search identified 5 other cases, including 2 presented only in the Italian or German literature
- 2/5 were in pts with preexisting neurologic disease, in which the neurologically affected side was spared
- 1 additional case initially presented as unilateral disease but rapidly progressed to bilaterality
- 2 cases presented in a fully unilateral manner despite no reported neurologic abnormalities on the unaffected sides
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