Unilateral RS3PE syndrome in a patient with hemiplegia
1Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan yasuhiro.kano.21@gmail.com.
BMJ Case Reports
|May 16, 2025
Summary
Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome typically presents symmetrically. This case highlights unilateral RS3PE in a hemiplegic patient, emphasizing atypical presentations in neurological deficits.
Area of Science:
- Rheumatology
- Neurology
- Clinical Case Study
Background:
- Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome is a rare autoimmune condition.
- Symmetrical swelling of hands/feet with pitting oedema is characteristic of RS3PE.
- Unilateral RS3PE is infrequently reported, often linked to rheumatic disorders and hemiplegia.
Purpose of the Study:
- To describe a unique case of unilateral RS3PE syndrome.
- To illustrate RS3PE syndrome occurring in a patient with pre-existing hemiplegia.
- To raise clinical awareness of non-symmetrical RS3PE presentations in patients with neurological deficits.
Main Methods:
- Case report detailing clinical presentation and diagnostic considerations.
- Review of literature concerning unilateral RS3PE and its association with neurological conditions.
Main Results:
- A patient with pre-existing hemiplegia presented with unilateral RS3PE syndrome.
- The case demonstrates that RS3PE can manifest asymmetrically, particularly in the presence of neurological deficits.
- This presentation challenges the classical understanding of RS3PE symmetry.
Conclusions:
- RS3PE syndrome does not always present symmetrically.
- Clinicians must consider atypical, unilateral presentations of RS3PE in patients with neurological deficits like hemiplegia.
- Increased clinical awareness is crucial for accurate diagnosis and management of RS3PE syndrome.
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