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Gastric adenocarcinoma presenting as a rheumatoid factor and anti-cyclic citrullinated protein antibody-positive polyarthritis: a case report and review of literature

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dc.contributor.authorSilvério-António, Manuel
dc.contributor.authorParlato, Federica
dc.contributor.authorMartins, Patrícia
dc.contributor.authorKhmelinskii, Nikita
dc.contributor.authorBraz, Sandra
dc.contributor.authorFonseca, João Eurico
dc.contributor.authorPolido Pereira, Joaquim
dc.date.accessioned2021-07-19T12:52:11Z
dc.date.available2021-07-19T12:52:11Z
dc.date.issued2021
dc.descriptionCopyright © 2021 Silvério-António, Parlato, Martins, Khmelinskii, Braz, Fonseca and Polido-Pereira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.pt_PT
dc.description.abstractA 64-year-old male presented with a 6-month history of symmetric polyarthritis involving proximal interphalangeal joints and metacarpophalangeal joints of the hands, wrists, and ankles. Associated symptoms included vomiting, progressive fatigue, and weight loss. Laboratory results showed microcytic anemia, leukocytosis, thrombocytosis, elevated C-reactive protein and erythrocyte sedimentation rate, and rheumatoid factor (RF) and anti-cyclic citrullinated protein (ACPA) antibody positivity. Joints radiographs were normal, without erosions. Upper endoscopy and gastric endoscopic ultrasonography showed a gastric adenocarcinoma with lymphatic involvement. Intraoperatively, peritoneal carcinomatosis was documented, and the patient started palliative chemotherapy. A paraneoplastic seropositive arthritis was assumed, and treatment with low-dose prednisolone and hydroxychloroquine was started. Arthritis remission was achieved and sustained up to 18 months of follow-up, although gastric cancer progression was documented. We describe a unique phenotype of paraneoplastic arthritis (PA) presenting as a seropositive (RF and ACPA positivity) rheumatoid arthritis (RA) with a good response to both low dose corticosteroids and hydroxychloroquine therapy. We also review the literature of PA, mostly the RA-like pattern, and the association between PA and ACPA positivity. This case highlights the importance of considering underlying cancer in elderly male patients, presenting with polyarthritis and systemic symptoms, even in those with ACPA-positive RA-like arthritis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFront Med (Lausanne). 2021 May 24;8:627004.pt_PT
dc.identifier.doi10.3389/fmed.2021.627004pt_PT
dc.identifier.eissn2296-858X
dc.identifier.urihttp://hdl.handle.net/10451/48994
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontierspt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/journals/medicine#pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectGastric cancerpt_PT
dc.subjectParaneoplastic arthritispt_PT
dc.subjectParaneoplastic syndromept_PT
dc.subjectRheumatoid arthritispt_PT
dc.subjectSeropositive arthritispt_PT
dc.titleGastric adenocarcinoma presenting as a rheumatoid factor and anti-cyclic citrullinated protein antibody-positive polyarthritis: a case report and review of literaturept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Medicinept_PT
oaire.citation.volume8pt_PT
person.familyNameAntónio
person.familyNameMartins
person.familyNameKhmelinskii
person.familyNameFonseca
person.familyNamePolido Pereira
person.givenNameManuel
person.givenNamePatrícia
person.givenNameNikita
person.givenNameJoão
person.givenNameJoaquim
person.identifier676523
person.identifier.ciencia-idA816-90BB-845E
person.identifier.ciencia-idF310-B85D-57C7
person.identifier.ciencia-id9812-232A-B282
person.identifier.orcid0000-0003-4936-0528
person.identifier.orcid0000-0003-3578-7213
person.identifier.orcid0000-0001-6358-7388
person.identifier.orcid0000-0003-1432-3671
person.identifier.orcid0000-0002-7188-8516
person.identifier.scopus-author-id7101983519
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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relation.isAuthorOfPublication.latestForDiscovery0a0fb8ca-e3e0-4e1c-a439-aecd0ed8cd66

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