[A case of polyarthritis developed on the non-paralytic side in a hemiplegic patient]

A 37-year old house wife who developed polyarthritis localized to contralateral to hemiplegic side was reported. The patient had been on the physical therapy program for right hemiplegia which occurred at the age of 33. The polyarthritis are chronic and showed significant responses to salazosulfapyridine. Her serum contained rheumatoid factor (RF) of high titer and hand X-ray showed characteristic erosive changes in PIP and MCP joints. Presence of morning stiffness, positive RF, bone erosion, isotope accumulation, HLA-DR4 and responses to DMARD are all consistent with a diagnosis of rheumatoid arthritis. Review of the literature revealed that fifteen patients had been reported in whom occurrence of neurological disorders and rheumatic conditions were described. In most of these patients including the present case, the rheumatic symptoms did not occur or subsided in the hemiplegic side of neurological disorders. Possible mechanisms of inactivation on rheumatic inflammation were discussed.