Lymphœdème des membres inférieurs : une manifestation rare des spondyloarthrites |
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| Institution: | 1. Department of Public Health and Infectious Diseases, Institute Pasteur, Cenci-Bolognetti Foundation, Sapienza University of Rome, P.le Aldo Moro, 5, 00185 Rome, Italy;2. Department of Neuroscience, Temple University School of Medicine, Philadelphia, USA;3. Department of the Science of Agriculture, Food and Environment (SAFE), University of Foggia, Italy;4. Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Italy;5. Department of Internal Medicine and Medical Disciplines, Rheumatology, “Sapienza” University of Rome, Italy;6. Department of Experimental and Clinical Sciences, “G. D’Annunzio” University of Chieti, Italy;7. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy;8. Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, Pennsylvania, USA;1. Service de médecine interne, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France;2. Service d’imagerie médicale, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France;3. Service de neurologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France;4. Service de gastro-entérologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France |
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| Abstract: | IntroductionSpondyloarthritis include articular (axial, peripheral or enthesitic) and extra-articular manifestations. We reported three cases of limb lymphedema associated with a spondyloarthritis.Case reportsWe report on two men and one female aged of 75, 52 and 39 years, respectively. The rheumatic disease was an ankylosing spondylitis HLA B27 positive in two patients and a psoriatic arthritis in the remaining one. Lymphedema, always unilateral, confirmed by the Stemmer's sign, involved the whole lower limb (n = 2) or only the foot and calf (n = 1). Lymphedema occurred 3 months, 40 and 9 years after the onset of spondyloarthritis. Lower limb lymphoscintigraphy was abnormal in all cases: decrease (n = 2) or absence (n = 1) of inguinal lymph node uptake, and visualization of the popliteal lymph node related to deep lymphatic pathway (n = 1). Treatment of the spondyloarthritis did not improve lymphedema. Both the low-stretch bandage and elastic compression treatment allowed its reduction and stabilization.ConclusionLimb lymphedema is a rare extra-articular manifestation of spondyloarthritis. Its course appears to be independent of joint disease. Its management is specific and should be associated to that of the rheumatologic disorder. |
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| Keywords: | Lymphedema Spondyloarthritis |
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