Table 3.
Characteristic features of published cases of RF and ACPA-positive paraneoplastic arthritis.
| Reference | Age/sex | Type of malignancy | Duration of symptoms preceding cancer diagnosis (months) | Family history of cancer | Arthritis location and pattern | Onset | Anemia | ESR (mm/h)/ CPR (mg/dl) | RF (IU/ml) /ACPA (IU/ml) | Joint radiographs | Response to NSAIDs | Response to corticosteroids | Cancer treatment used (response or evolution) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Kumar et al. (11) | 58/M | Pancreatic cancer | 2 | N.M. | No arthritis; arthralgia involving hands, wrists, elbows, shoulders, lower back, and neck; asymmetric and intermittent | Gradual | Yes | ++/N.M. | +++/++ | N.E. | N.M. | Yes | None (died) |
| Raja et al. (10) | 40/M | Lymphomatoid granulomatosis | 3–4 | No | Wrists, knees, and ankles; symmetric | Gradual | No | –/+ | ++/++ | N.E. | N.M. | Yes (partial) | None (died) |
| Larson et al. (8) | 45/F | Lung adenocarcinoma | 3 | No | PIP, MCP, elbows, and knees; symmetric | N.M. | No | –/+ | ++/+ | N.E. | No | Yes (partial) | None (died) |
| Handy et al. (4) | 61/F | T cell lymphoblastic leukemia | 1–2 | No | MCP, wrists, knees, and ankles; symmetric | Acute | Yes | +++/++ | +++/++ | Erosions | No | No | Hyper-CVAD CMT (refractory) |
| Watson et al. (9) | 80/F | Breast papillary cancer | 1 | N.M. | Shoulder arthritis; arthralgia involving wrists, shoulders, and knees; asymmetric and migratory | Acute | Yes | –/++ | +/+ | N.E. | No | Yes | CMT (N.M) and RT (remission) |
| Present case | 64/M | Gastric adenocarcinoma | 6 | Yes (GI and lung) | PIP, MCP, wrists, and ankles; symmetric | Gradual | Yes | ++/+++ | ++/++ | N.E. | No | Yes | 5-FU and CIS CMT (not curative) |
CPR, C-reactive protein; ESR, erythrocyte sedimentation rate; ACPA, anti-cyclic citrullinated peptide antibodies; RF, rheumatoid factor; NSAIDs, non-steroidal anti-inflammatory drugs; F, female; M, male; GI, gastrointestinal; MCP, metacarpophalangeal joints; PIP, proximal interphalangeal joints; 5-FU, fluorouracil; CIS, cisplatin; hyper CVAD, cyclophosphamide, vincristine, doxorubicin, and dexamethasone; CMT, chemotherapy; RT, radiotherapy; N.E., no erosions; N.M., not mentioned.
ESR: – if <30, + if ≥30, and <60, ++ if ≥60 and <100, +++ if ≥100.
CPR: + if ≥0.5 and <5.0, ++ if ≥5.0 and <15.0, +++ if ≥15.0.
RF titer: + if ≥14 and <100, ++ if ≥100 and <300, +++ if ≥300.
ACPA: + if ≥20 and <100, ++ if ≥100 and <300, +++ if ≥300.