DOI: 10.36347/sjmcr.2022.v10i06.010

Pages: 539-541

Introduction: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare clinical entity characterized by “remitting,” “seronegative,” and “symmetrical” synovitis with pitting edema on the dorsum of the hands and feet. Although rheumatic or malignant diseases are diseases that are known to coexist with RS3PE, other factors such as medication, infection, and vaccination have been reported to be associated with RS3PE. Objectif: To report the case of an 81-year-old man without rheumatic ATCD who had an RS3PE resulting from vaccination against Covid 19, based on an mRNA vaccine (BNT162b2 mRNA) and supported in our training in January 2022. Case report: An 81-year-old man, with cardiovascular risk factors such as type 2 diabetes on metformin, well-balanced hypertension, and a history of hiatal hernia complicated by iron deficiency anemia, was followed up for moderate IM valve disease under treatment. The patient presented to the emergency room with lower limb oedema, and inflammatory arthritis that had been evolving for 2 months. Three days after receiving the third dose of Pfizer's covid 19 (BNT162b2 mRNA) vaccine, the patient presented with bilateral inflammatory polyarthritis and symmetric large joints. The joint involvement was associated with swelling of the hands and feet. The hemogram showed lymphopenia at 900elements/mm3 and CRP at 140mg/L, SV at 76mm and D-dimer at 3000ng/ml. Having first ruled out a cardiac, hepatic or renal origin, we then ruled out inflammatory rheumatism, connectivitis or small vessel vasculitis. In search of the origin of this picture, the thoraco-abdomino-pelvic scanner was in favor of an inhalation pneumonia and a hiatal hernia. He ruled out a probable solid neoplastic origin. The PSA was normal. We retained the diagnosis of RS3PE secondary to vaccination as the only triggering factor for this syndrome. The patient was put on oral corticosteroid therapy with rapid degression and adjuvant treatment. .................