[RS3PE syndrome-A rare facultative paraneoplasm]

The remitting seronegative symmetric synovitis with pitting edema (RS3PE) syndrome is a rare inflammatory rheumatic disease of older adults, which can also be paraneoplastic. The main symptom is a rapidly progressing symmetric edematous swelling of both hands, sometimes also both feet, accompanied by (teno-)synovitis. Autoimmune serologies (rheumatic factor, antibodies against cyclic citrullinated peptides, antinuclear antibodies) typically remain negative. When a diagnosis of RS3PE is made, age-appropriate screening investigations for malignancies should be carried out. In addition, a comprehensive history should be taken and physical examination should be performed focusing on signs of neoplasia, followed by further investigations if necessary. The RS3PE syndrome typically shows an excellent response to treatment with glucocorticoids. A drug-free remission is frequently achieved but sometimes treatment with disease-modifying antirheumatic drugs (DMARDs) is necessary.