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
A 71-year-old woman was referred to our hospital with finger stiffness; edema of both hands and feet; and bilateral pain in the shoulder, wrist, metacarpophalangeal, proximal interphalangeal, and ankle joints.
Physical examination showed remarkable pitting edema in the dorsum of the hands and feet, as well as bilateral tenderness and swelling in the shoulder, wrist, finger, and ankle joints.
Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome and rheumatoid arthritis were considered.
Blood test results were as follows: WBC, 5100/μL (neutrophils, 75%); CRP, 20.8 mg/dL; erythrocyte sedimentation rate, 99 mm/h; RF, negative; matrix metalloproteinase 3 (MMP-3) 488 ng/mL; VEGF, 135 pg/mL; HLA-B 7, (+).
Treatment with prednisolone (15 mg/d) was started.
We report a patient with RS3PE syndrome and elevation of MMP-3. MMP-3 was more indicative of RS3PE syndrome symptoms than was CRP.