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Palindromic rheumatism. Clinical and serum complement study

M A Wajed, D L Brown, H L Currey

    Annals of the Rheumatic Diseases
    |February 1, 1977
    PubMed
    Summary

    Palindromic rheumatism often evolves into rheumatoid arthritis (RA), indicating it may not be a distinct condition. Early signs like inflammation and positive serology predict RA development.

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    Area of Science:

    • Rheumatology
    • Immunology

    Background:

    • Palindromic rheumatism is an episodic joint condition.
    • Its relationship to rheumatoid arthritis (RA) requires clarification.

    Purpose of the Study:

    • To investigate the natural history of palindromic rheumatism.
    • To determine if palindromic rheumatism is a distinct entity from RA.

    Main Methods:

    • Review of 39 patients diagnosed with palindromic rheumatism.
    • Analysis of clinical, radiological, and serological data.
    • Comparison of patients who evolved to RA versus those who remained palindromic.

    Main Results:

    • 17 of 39 patients developed typical rheumatoid arthritis (RA).
    • 22 patients remained palindromic.
    • Early RA development was associated with minor clinical/radiological changes, elevated erythrocyte sedimentation rate, and positive serology.
    • Disease severity in palindromic-onset RA was comparable to other RA cases.
    • No complement component reduction was observed during attacks, despite fluid retention history in some patients.

    Conclusions:

    • Palindromic rheumatism appears to be a form of RA with a palindromic onset rather than a separate condition.
    • Early indicators can predict the evolution to RA.
    • The pathogenesis involving immune complexes and vascular permeability requires further investigation.

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