Abstract
Background A 58-year-old woman presented with arthritis of the small joints of her hands and rapidly progressive joint contractures. She was wheelchair bound within 2 months of the onset of her symptoms. Physical examination revealed synovitis of the small joints of her hands and palmar fasciitis. The patient had been diagnosed with pancreatic carcinoma approximately 1 year before the presentation of her rheumatic symptoms, and had undergone radical pancreatico-duodenectomy.
Investigations Physical examination; routine laboratory work, including full blood count and measurement of erythrocyte sedimentation rate and C-reactive protein; serological tests for rheumatoid factor, antinuclear antibodies and extractable nuclear antibodies; measurement of serum tumor markers; radiological investigations, including X-rays of her hands and feet, whole-body CT-scans and radioisotope bone scan.
Diagnosis The patient's rheumatic presentation was diagnosed as a paraneoplastic syndrome associated with pancreatic carcinoma.
Management The patient's condition was managed with corticosteroids and methotrexate. No residual tumor or evidence of metastatic disease have been detected in the 1.5 years since the initial presentation of her rheumatic symptoms.
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References
Medsger TA et al. (1982) Palmar fasciitis and polyarthritis associated with ovarian carcinoma. Ann Intern Med 96: 424–431
Michaels RM and Sorber JA (1984) Reflex sympathetic dystrophy as a probable paraneoplastic syndrome: case report and literature review. Arthritis Rheum 27: 1183–1185
Baer AN and Phillips RM Jr (1983) Pancreatic carcinoma and palmar fasciitis. Ann Intern Med 99: 411–412
Shiel WC Jr et al. (1985) Palmar fasciitis and arthritis with ovarian and non-ovarian carcinomas. New syndrome. Am J Med 79: 640–644
Valverde-Garcia J et al. (1987) Paraneoplastic palmar fasciitis-polyarthritis syndrome associated with breast cancer. J Rheumatol 14: 1207–1209
Pfinsgraff J et al. (1986) Palmar fasciitis and arthritis with malignant neoplasms: a paraneoplastic syndrome. Semin Arthritis Rheum 16: 118–125
Mathieu E et al. (1991) Palmar fasciitis arthritis syndrome revealing relapse of chronic lymphoid leukaemia [French]. Presse Med 20: 521
Roche CJ et al. (2003) CT and pathologic assessment of prospective nodal staging in patients with ductal adenocarcinoma of the head of the pancreas. AJR Am J Roentgenol 180: 475–480
Seaman JM et al. (1985) Fasciitis and polyarthritis during antituberculous therapy. Arthritis Rheum 28: 1179–1184
Laszlo KS et al. (1995) Idiopathic palmar fasciitis. Int J Dermatol 34: 658–660
Sung YK et al. (2006) Idiopathic palmar fasciitis with polyarthritis syndrome. J Korean Med Sci 21: 1128–1132
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Haroon, M., Phelan, M. A paraneoplastic case of palmar fasciitis and polyarthritis syndrome. Nat Rev Rheumatol 4, 274–277 (2008). https://doi.org/10.1038/ncprheum0768
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DOI: https://doi.org/10.1038/ncprheum0768
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