RS3PE Syndrome with Subsequent PMR Caused by Long-Term DPP-4 Inhibitor Use

Yuichi Takahashi; Gautam A Deshpande; Yoshinori Kanai; Kwang Seok Yan; Toshio Naito

doi:10.12890/2023_003914

RS3PE Syndrome with Subsequent PMR Caused by Long-Term DPP-4 Inhibitor Use

Eur J Case Rep Intern Med. 2023 Jun 12;10(7):003914. doi: 10.12890/2023_003914. eCollection 2023.

Authors

Yuichi Takahashi¹, Gautam A Deshpande¹, Yoshinori Kanai¹, Kwang Seok Yan¹, Toshio Naito¹

Affiliation

¹ Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.

Abstract

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome has been reported in patients treated with dipeptidyl peptidase-4 inhibitors (DPP-4i). We experienced a case of RS3PE syndrome in a 73-year-old man with a history of type 2 diabetes, who developed RS3PE as a side effect of vildagliptin. Further to this, the patient developed polymyalgia rheumatica (PMR), the first such case associated with long-term DPP-4i use.

Learning points: RS3PE syndrome and PMR are rare diseases that cause painful extremities in adults. We need to know if it occurs by DPP-4i.RS3PE syndrome and PMR can be complicated with malignancy or giant cell arteritis. However, we must rule out side effects of drugs at first from the standpoint of medical resources.

Keywords: RS3PE syndrome; dipeptidyl peptidase (DPP-4); polymyalgia rheumatica (PMR); side effect.