Syndrome of Remitting Seronegative Symmetrical Synovitiswith Pitting Edema (RS3PE): A Case Report and Review of the Literature

Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) is a rare clinical entity that is easily missed due to lack of knowledge. Syndrome is characterized by sudden onset of edema with swelling on the dorsum of the hands and by synovitis. Serological tests are negative and radiographic joint destruction does not occurs. Etiology of RS3PE syndrome is not known. It can occur as an idiopathic phenomenon, but also is in association with rheumatic diseases. In addition, several reports have described RS3PE as a paraneoplastic syndrome can occur on concomitantly with both hematological and solid malignancies. Because of this clinical association, it is not very easy to diagnose this syndrome. We discuss a case of RS3PE where the patient presented with acute onset polyarthritis and pitting edema of the extremities without an underlying systemic cause. Patient showed dramatic response with low dose steroid therapy.