Paraneoplastic Migratory Oligoarthritis in a Patient With Malignant Mesothelioma

Our plain-English summary of Paraneoplastic Migratory Oligoarthritis in a Patient With Malignant Mesothelioma, by M. Eidenschink, A. Beard, D. Ewart (The American Journal of Medicine, 2019).

The study

• Authors: M. Eidenschink, A. Beard, D. Ewart
• Journal: The American Journal of Medicine
• Published: 2019;132(11):e801-e802
• Type of article: Case report, Letter
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report about one patient. A 73-year-old Navy veteran recently diagnosed with malignant mesothelioma came to the authors' hospital with two days of worsening left knee pain. Fluid drawn from the swollen knee was full of white blood cells, but a Gram stain found no bacteria and no crystals were seen. Over the next days his left shoulder and then his right wrist became swollen and painful. Fluid from the shoulder showed 169,000 white blood cells per cubic millimeter, again without crystals or bacteria. Blood and joint cultures grew nothing. Tests for Lyme disease and for rheumatoid factor and anti-citrullinated cyclic peptide antibody were negative. Antibiotics were stopped. He improved on naproxen and had no further arthritis after starting chemotherapy. The authors concluded that this pattern suggested paraneoplastic inflammatory arthritis. They stated that, to their knowledge, this was the first such case described with malignant mesothelioma. The report did not describe any asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (clinical communication to the editor)
• Who was studied: one 73-year-old male Navy veteran recently diagnosed with malignant mesothelioma, treated at the Minneapolis Veterans Affairs Medical Center
• Exposure: No asbestos or other exposure was described; the patient was identified only as a Navy veteran
• Main results:
  • Fluid from the left knee contained 50,250 white blood cells per cubic millimeter, mostly neutrophils; Gram stain was negative and no crystals were seen
  • On hospital day 2 the left shoulder became swollen; fluid from it contained 169,000 white blood cells per cubic millimeter, again without crystals or bacteria
  • On day 4 the right wrist became similarly swollen, warm and painful
  • Gram stains and cultures were negative and no crystals were found, which the authors said ruled out septic or crystal arthritis
  • Lyme immunoassay, anti-citrullinated cyclic peptide antibody and rheumatoid factor were negative
  • The knee and shoulder improved with naproxen; after starting chemotherapy the patient had no recurrent arthritis
  • The authors judged the course to be suggestive of paraneoplastic inflammatory arthritis
• The authors' conclusion: The authors concluded that the patient's arthritis was suggestive of paraneoplastic inflammatory arthritis and stated that, to their knowledge, this was the first instance described in association with malignant mesothelioma

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma.

Related studies

• Rheumatoid lung changes associated with asbestosis — A.G. Rickards, G.M. Barrett (1958)
• Rheumatoid pneumoconiosis (Caplan's syndrome) in an asbestos worker — W.G. Tellesson (1961)
• Leser–Trélat syndrome in malignant mesothelioma and pulmonary adenocarcinoma: is the EGFR pathway part of the syndrome? — R.K. Jepsen, A.G. Skov, et al. (2014)
• Malignant Peritoneal Mesothelioma Presenting with Polymyalgia Rheumatica-like Syndrome — Y. Ide, T. Yuki, et al. (2020)
• Epigenetic down-regulation of integrin α7 increases migratory potential and confers poor prognosis in malignant pleural mesothelioma — V. Laszlo, M.A. Hoda, et al. (2015)
• Anti-Yo antibody-mediated paraneoplastic cerebellar degeneration in a female patient with pleural malignant mesothelioma — O. Tanriverdi, N. Meydan, et al. (2013)

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