Guo H, Liang Q, Dong C, Zhang Q, Gu ZF. Systematic review of fibroblastic rheumatism: A case report. World J Clin Cases 2023; 11(21): 5136-5146 [PMID: 37583864 DOI: 10.12998/wjcc.v11.i21.5136]
Corresponding Author of This Article
Zhi-Feng Gu, PhD, Chief Doctor, Department of Rheumatology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong 226001, Jiangsu Province, China. guzf@ntu.edu.cn
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hua Guo, Qian Liang, Chen Dong, Zhi-Feng Gu, Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
Qing Zhang, Department of Pathology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
Author contributions: Guo H was designed, conducted and manuscript writing; The data were collected primarily by Liang Q and Dong C; Statistical analysis and manuscript writing were partly completed by Zhang Q and Gu ZF; All authors agreed to publish the final manuscript in this journal.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no financial or other conflicts of interest related to this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Feng Gu, PhD, Chief Doctor, Department of Rheumatology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong 226001, Jiangsu Province, China. guzf@ntu.edu.cn
Received: April 18, 2023 Peer-review started: April 18, 2023 First decision: May 19, 2023 Revised: June 14, 2023 Accepted: July 6, 2023 Article in press: July 6, 2023 Published online: July 26, 2023
Abstract
BACKGROUND
Fibroblastic rheumatism (FR) is a rare fibroproliferative disease with an unknown etiology. The absence of typical symptoms makes early diagnosis challenging. This study aims to systematically review FR cases and present a case from our center to provide a comprehensive description of the clinical manifestations, diagnosis, and treatment, thereby assisting clinicians in early identification and timely management of FR, ultimately leading to improved prognosis.
CASE SUMMARY
FR is a rare fibroproliferative disease with an unknown etiology. It is characterized by rapidly progressive and destructive symmetrical inflammatory multiple arthritis. Here, we present a rare case of a 50-year-old female with symmetric inflammatory polyarthritis. We highlight the importance of a comprehensive medical history, histopathology, immunohistochemistry, and clinical manifestations of skin nodules, arthralgia, and arthritis for successful disease diagnosis. Despite employing non-steroidal anti-inflammatory drugs, corticosteroids, methotrexate, and tacrolimus, the patient's symptoms did not resolve, and joint destruction continued to progress. Early diagnosis, aggressive treatment with appropriate use of steroids and immunosuppressants, and further research to identify effective treatment strategies are crucial in preventing detrimental joint destruction and limb contractures.
CONCLUSION
A comprehensive review of the available literature emphasizes the importance of early and accurate diagnosis coupled with appropriate treatment for achieving favorable outcomes and preventing joint destruction and limb contractures.
Core Tip: Fibroblastic rheumatism is a rare fibroproliferative disease with unknown etiology characterized by onset of rapidly progressive and destructive symmetrical inflammatory multiple arthritis. We report a rare case of a 50-year-old female presented with symmetric inflammatory polyarthriti. We found that a complete medical history, histopathology, and immunohistochemistry combined with clinical manifestations of skin nodules, arthralgia, and arthritis are the keys to a successful diagnosis of this disease. In terms of treatment, our patient was similarly treated with non-steroidal anti-inflammatory drugs, corticosteroids, methotrexate, and tacrolimus, but the symptoms did not resolve and the joint destruction continued to develop. All in all, early diagnosis and aggressive and correct use of steroids and immunosuppressants are essential to prevent potentially harmful joint destruction and limb contracture. Meanwhile, further research is needed to determine effective treatment strategies.
