Clinical analysis of 20 cases of paraneoplastic syndrome with prominent osteoarticular involvement
10.3760/cma.j.issn.1007-7480.2019.03.010
- VernacularTitle:以骨关节受累为突出表现的副肿瘤综合征20例临床分析
- Author:
Hongchao LI
1
;
Shumin YAN
;
Siliang MAN
;
Yanhong HUANG
;
Hui SONG
;
Husheng WU
Author Information
1. 北京积水潭医院风湿免疫科
- Keywords:
Neoplasms;
Paraneoplastic syndrome;
Osteoarthropathy
- From:
Chinese Journal of Rheumatology
2019;23(3):188-192
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of paraneoplastic syndrome with prominent osteoarticular involvement. Methods The clinical materials of 20 patients with paraneoplastic syndrome with prominent osteoarticular involvement were collected. The characteristics of clinical manifest-ations, laboratory tests and imagines were analyzed. Results Among the 20 patients, 16 were male and 4 were female, with a mean age of 44.5 years and a median course of 6 months. Ten cases were associated with hematological tumor and 10 cases were associated with solid tumor. Eleven cases presented as peripheral arthritis (7 cases of polyarthritis, 4 cases of oligoarthritis/monoarthritis), 5 cases presented with hypertrophic osteoarthropathy (HOA) and 4 cases presented with tumor-induced osteomalacia (TIO). Three cases were acute lymphocytic leukemia, 2 cases were multiple myeloma, 1 case was lymphoma, and 1 case was bone tumor in polyarthritis. Four oligoarthritis cases were all associated with acute lymphocytic leukemia. All 5 cases of HOA were associated with lung cancer. All 4 cases of TIO were associated with tumor of mesenchymal tissue. Extra-articular manifestations presented in 14 cases and inflammatory markers increased in 15 cases. anti-cyclic cirullinated peptide (anti-CCP) antibodies was low titer positive in only 1 case and other parameters including rheumatoid factor (RF), anti-CCP antibodies, antinuclear antibodies spectrum (ANAs) and human leukocyte antigen (HLA)-B27 were negative. Multiple bone imaging abnormalities appeared in 15 cases. Conclusion Osteoarticular manifestations may be the first symptom of malignancy and difficult to diagnose. It is necessary to be highly aware of potential malignancy.
