Palindromic Rheumatism: A Clinical Survey of Sixty Patients

Abstract

Sixty patients with palindromic rheumatism (PR) with a total follow-up time of 598 years and 295 years prospectively are presented. The study shows that PR is not a rare condition, but the syndrome is often ignored or misdiagnosed by the physician. Most cases of PR appear to evolve into chronic arthritis. PR may precede other kinds of systemic diseases, such as SLE, Wegener's granulomatosis, and multiple myeloma. The presence of PR in patients with fibromyalgia is reported in this paper. Gold appears to be the best drug for the treatment of PR. Cases of fibromyalgia and PR are treated successfully with antimalarial drugs. Our proposed diagnostic criteria for PR are as follows: 1) recurrent attacks of sudden-onset mono or polyarthritis or of periarticular tissue inflammation, lasting from a few hours to one week; 2) verification of at least one attack by a physician; 3) subsequent attacks in at least three different joints; 4) exclusion of other forms of arthritides.

Reumatismo palindrómico (Enfermedad de Hench Rosemberg): Caso clínico con respuesta a los glucocorticoides

“…Es característico el gran compromiso de partes blandas que acompaña la afección generando intenso dolor [3][4][5]15 . Si bien es habitual que la afección dure menos de 48 hs, se ha descripto un subgrupo de pacientes que presenta un curso más prolongado 7,8,10 , como el que observamos en nuestro paciente.…”

“…El examen del líquido articular mostró recuento celular a predominio mononuclear de 2.800/mm 3 , sin cristales y sin gérmenes y 4 pares de hemocultivos y 2 urocultivos fueron negativos. El examen radiológico de tórax, y de las regiones comprometidas (pies, manos y rodillas) no evidenció lesiones, calcificaciones intraarticulares o condrocalcinocis.…”

A Patient with Severe Palindromic Rheumatism and Frequent Episodes of Pain.

“…Manyof these patients are already positive for serum rheumatoid factor and HLADR-4(3). Other patients maybecomepositive for rheumatoid factor at the time that rheumatoid arthritis actually develops (4,5). In addition, some reports have described patients with palindromic rheumatism whohave developed other collagen vas- cular disorders such as systemic lupus erythematosus (2,5).…”

“…Given the relatively high rate of transition from palindromic rheumatismto rheumatoid arthritis, the use of antirheumatic drugs should also be considered in patients whodevelop other findings suggestive of early rheumatoid arthritis. Chloroquine has been reported to be effective for treatment of palindromic rheumatism (4,9), but the production of this drug has been discontinued in Japan. Therapy with colchicine has been evaluated in patients who failed to respond adequately to heat therapy.…”

Von Recklinghausen Disease with Palindromic Rheumatism

“…The most commonly affected joints are finger joints, wrists, and knees; however, other joints often are involved. Despite the occurrence of frequent attacks, the arthritis of palindromic rheumatism characteristically is non-deforming [4]. Here, we present a 59-year-old female with NF1 who visited our clinic with diffuse pain and joint swelling attacks and diagnosed as palindromic rheumatism.…”