Palindromic rheumatism (PR) is an autoimmune related disease characterized by sudden, multiple, and recurring attacks of joint pain and swelling, typically in the hands and feet. Each episode may last from several hours to several days. The frequency of attacks also varies, from one episode a day to several during the course of a year. Between attacks, the symptoms disappear and the affected joints appear normal on x-ray exams. The cause of palindromic rheumatism is unknown, although a possible allergic origin has been suggested. There may also be a clinical association between antiphospholipid syndrome and palindromic rheumatism. Some individuals with palindromic rheumatism develop chronic joint inflammation and go on to develop rheumatoid arthritis.
Palindromic rheumatism (PR) is a type of recurrent arthritis characterized by episodes or “attacks” of joint inflammation, sequentially affecting one to several joint areas for hours to days.[1][2] A PR attack often occurs suddenly without any obvious triggers or warning symptoms. Any joint(s) may be affected, but finger joints, wrists, and knees are most commonly affected.[2] Symptoms during episodes may include pain, swelling, stiffness, and redness in and around the joints.[2] Some people may have a fever and other systemic symptoms.[3] Between episodes, people with PR have no symptoms.[2] The time between episodes may last from days to months.[1]
The underlying cause of PR is not known.[2] Some people with PR eventually develop chronic rheumatic disease, the most common being rheumatoid arthritis (RA). Others may develop lupus and/or other systemic disorders. People with anti-CCP antibodies detected in a blood test appear more likely to develop RA.[1] There has been some evidence to support that PR can be a presenting feature of RA (or part of the spectrum of RA), rather than a distinct condition.[2] [4]
Treatment of PR is challenging, as it has not been studied in randomized trials.[5] Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to treat acute episodes. Disease-modifying antirheumatic drugs (DMARDs) may be an option for those with refractory, frequent attacks.[5] Hydroxychloroquine (a DMARD) reportedly may help control attacks and reduce the risk of progression to RA.[2][4]
This information is provided by the National Institutes of Health (NIH) Genetic and Rare Diseases Information Center (GARD).
https://rarediseases.info.nih.gov/diseases/7304/palindromic-rheumatism
FAQs
Palindromic rheumatism (PR) is an autoimmune related disease characterized by sudden, multiple, and recurring attacks of joint pain and swelling, typically in the hands and feet. Each episode may last from several hours to several days.
How rare is palindromic arthritis? ›
Palindromic rheumatism is rare, so your GP may not have seen many cases. It can sometimes be confused with conditions like gout and rheumatoid arthritis.
How painful is palindromic rheumatism? ›
During an attack of palindromic rheumatism, the joints involved – and the tendons and area around them – will feel painful and stiff and may look swollen. They might also feel tender and hot, and the skin over your joints may look red. your skin. Relaxation exercises can also help.
What is the outlook for palindromic rheumatism? ›
According to Arthritis Research UK, the outlook for palindromic arthritis is as follows: around 10 to 15 percent of people will see their symptoms disappear. around 30 to 50 percent will have only occasional attacks.
What is the best treatment for palindromic rheumatism? ›
Non-steroidal anti-inflammatory drugs were the most commonly reported treatments for flares of PR, with variable results. Anti-malarials, such as hydroxychloroquine and chloroquine phosphate, showed efficacy in reducing the frequency of the flares and, to a lesser extent, in preventing progression to RA.
What does palindromic mean in medical terms? ›
: of, relating to, or consisting of a double-stranded sequence of DNA in which the order of the nucleotides is the same on each side but running in opposite directions.
What is the rarest form of rheumatoid arthritis? ›
Palindromic rheumatism is a rare condition where symptoms like those of rheumatoid arthritis – joint inflammation, pain and swelling – come on suddenly and then disappear just as quickly. Palindromic rheumatism (PR) is a rare type of inflammatory arthritis.
Can you work with reactive arthritis? ›
If you have arthritis or joint pain, your condition may pose some challenges which could make your working life harder. However, work is certainly feasible for most people with arthritis or a related condition.
What exercises are good for palindromic rheumatism? ›
Exercise is important to improve muscle strength and joint flexibility but some people find exercise difficult due to fatigue. Some people with palindromic rheumatism find that mild, low impact exercises such as yoga, aqua therapy and stretching are beneficial. When the pain is severe, resting the joints is best.
Can palindromic rheumatism go into remission? ›
Not all patients with PR will develop RA; clinical remission is seen in about 15% of cases [11], and recurrent attacks without persistent joint involvement continue in 40–50% of cases [12].
We report a case of rheumatoid nodules of the lung seen in a patient with palindromic rheumatism. A 54-year-old man with palindromic rheumatism was admitted for evaluation of three nodules in the right upper lobe on chest roentgenogram.
What is the prognosis for palindromic rheumatism? ›
Objective: Palindromic rheumatism is characterized by attacks of acute arthritis of short duration. In the long term, a substantial proportion of patients will develop rheumatoid arthritis (RA) or other connective tissue diseases, but the determinants of subsequent chronic disease have not been adequately established.
Are there any support groups for palindromic arthritis? ›
International Palindromic Rheumatism Society - National Organization for Rare Disorders.
Can COVID cause palindromic rheumatism? ›
Abstract. A 33-year-old woman developed palindromic rheumatism (PLR) several weeks following an infection with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2).
What is meant by palindromic sequence? ›
In molecular biology, palindromic sequences are referred to as the sequence of nucleotides in the DNA duplex or RNA, where the sequence in one strand is the same as the complementary sequence of the other strand when read from the same direction on both the strands, either 5' to 3' or 3' to 5'.
What were your first signs of rheumatoid arthritis? ›
Symptoms
- Tender, warm, swollen joints.
- Joint stiffness that is usually worse in the mornings and after inactivity.
- Fatigue, fever and loss of appetite.
