Published online May 16, 2018. doi: 10.12998/wjcc.v6.i5.84
Peer-review started: December 22, 2017
First decision: February 9, 2018
Revised: February 15, 2018
Accepted: March 7, 2018
Article in press: March 7, 2018
Published online: May 16, 2018
We report a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a 71-year-old woman. She referred to our hospital with finger stiffness, edema of both hands and feet, pain of bilateral shoulder, wrist, metacarpophalangeal, proximal interphalangeal, and ankle joints. Rheumatoid factor was negative, human leukocyte antigen -B7 antigen was positive. Moreover, matrix metalloproteinase 3 (MMP-3) was high. She was diagnosed with RS3PE syndrome, and treatment with prednisolone (15 mg/d) was started. One week after prednisolone treatment initiation, CRP decreased to negative, and joint pain was almost completely resolved. However, hand stiffness persisted, and MMP-3 level was still high. Thus, prednisolone dose was increased to 20 mg/d, and the stiffness resolved. Twenty days after treatment initiation, MMP-3 was normalized. MMP-3 was more indicative of RS3PE syndrome symptoms than CRP. Thus, MMP-3 seems to be more sensitive to RS3PE syndrome symptoms.
Core tip: We report a patient with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome and elevation of matrix metalloproteinase 3 (MMP-3). MMP-3 was more indicative of RS3PE syndrome symptoms than CRP. Although the study of additional cases is necessary, MMP-3 seems to be more sensitive to RS3PE syndrome symptoms.