Vol.22 No.4

Original Article

High serum matrix metalloproteinase 3 is characteristic of patients with paraneoplastic remitting seronegative symmetrical synovitis with pitting edema syndrome

Authors

Tomoki Origuchi1,2 , Kazuhiko Arima2 , Shin-ya Kawashiri2 , Mami Tamai2 , Satoshi Yamasaki2 , Hideki Nakamura2 , Toshiaki Tsukada3 , Toshiyuki Aramaki4 , Masako Furuyama5 , Taiichiro Miyashita6 , Yojiro Kawabe7 , Nozomi Iwanaga8, Kaoru Terada8, Yukitaka Ueki8, Takaaki Fukuda9, Katsumi Eguchi10, Atsushi Kawakami2

  • Department of Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
  • Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
  • Department of Internal Medicine, Isahaya Health Insurance General Hospital, 24-1 Eishohigashi-machi, Isahaya, 854-0071, Japan
  • Department of Internal Medicine, Nagasaki Atomic Bomb Hospital, 3-15 Morimachi, Nagasaki, 852-8511, Japan
  • Department of Rheumatology, Nagasaki Kita Hospital, 800 Motomura-go, Togitsu-cho, Nishisonogi-gun, 851-2103, Japan
  • Department of General Medicine, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kuhara, Omura, 856-8562, Japan
  • Department of Rheumatology, National Hospital Organization Ureshino Medical Center, 2436 Oaza Geshukuhei, Ureshino-cho, Ureshino, 843-0393, Japan
  • Department of Rheumatology, Sasebo Chuo Hospital, 15 Yamato-cho, Sasebo, 857-1195, Japan
  • Department of Rheumatology, Kurume Medical Center, 155-1 Kokubu-machi, Kurume, 839-0863, Japan
  • Department of Internal Medicine, Sesebo Municipal Hospital, 9-3 Hirase-machi, Sasebo, 857-8511, Japan
Received:

4 August 2011

Accepted:

31 October 2011

Published online:

17 November 2011

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Abstract

Recently, it was reported that remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome could be complicated with solid tumors. In a retrospective, multicenter study between October, 2003 and September, 2010, we investigated the characteristics of patients with paraneoplastic RS3PE syndrome who fulfilled following criteria: (1) bilateral pitting edema of hands or feet or both, (2) sudden onset of polyarthritis, and (3) age >50 years, (4) seronegativity for rheumatoid factor (RF). A total of 33 cases fulfilled the above criteria. Eight patients (seven men and one woman) developed cancer within 2 years of RS3PE syndrome onset. There was no significant difference between the neoplastic and nonneoplastic groups in the proportions of patients with fever, symmetrical polyarthritis, pitting edema, and good response to corticosteroids. Serum matrix metalloproteinase 3 (MMP-3) level (median 437.3 ng/ml) in the paraneoplastic RS3PE patients was significantly higher than that in patients without neoplasia (median 114.7 ng/ml) (p<0.05). We found that high serum MMP-3 is characteristic of patients with paraneoplastic RS3PE syndrome.

Key words

Remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE syndrome) - Matrix metalloproteinase 3 - Neoplasia