{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:45:58Z","timestamp":1782603958916,"version":"3.54.5"},"reference-count":9,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,12]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare inflammatory condition that occurs in older adults. Here, we report a case of an 80-year-old man with no history of rheumatic disease who presented with acute onset of bilateral hand pain, pitting oedema and synovitis after the second dose of the BNT162b2 mRNA C0VID-19 vaccine. Laboratory workup revealed elevated inflammatory markers and negative autoantibodies. Significant improvement was noted with prednisolone. This is the first reported case of RS3PE in an elderly patient with no previous rheumatic disease following mRNA COVID-19 vaccination.<\/jats:p>","DOI":"10.1136\/bcr-2021-244479","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T12:45:59Z","timestamp":1628081159000},"page":"e244479","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Remitting seronegative symmetrical synovitis with pitting oedema following BNT162b2 mRNA COVID-19 vaccination"],"prefix":"10.1136","volume":"14","author":[{"given":"Konstantinos","family":"Parperis","sequence":"first","affiliation":[{"name":"The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA"},{"name":"University of Cyprus Medical School, Nicosia, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Constantinou","sequence":"additional","affiliation":[{"name":"University of Cyprus Medical School, Nicosia, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,4]]},"reference":[{"key":"2025082707362716000_14.8.e244479.1","doi-asserted-by":"crossref","DOI":"10.1093\/femspd\/ftaa025","article-title":"Long-Term and herd immunity against SARS-CoV-2: implications from current and past knowledge","volume":"78","author":"Papachristodoulou","year":"2020","journal-title":"Pathog Dis"},{"key":"2025082707362716000_14.8.e244479.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2021.04.047"},{"key":"2025082707362716000_14.8.e244479.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03360190069027"},{"key":"2025082707362716000_14.8.e244479.4","doi-asserted-by":"crossref","DOI":"10.1007\/s11926-015-0525-0","article-title":"RS3PE: clinical and research development","volume":"17","author":"Li","year":"2015","journal-title":"Curr Rheumatol Rep"},{"key":"2025082707362716000_14.8.e244479.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.032995"},{"key":"2025082707362716000_14.8.e244479.6","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.semarthrit.2017.03.003","article-title":"Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome induced by nivolumab","volume":"47","author":"Gauci","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2025082707362716000_14.8.e244479.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-005-0157-2"},{"key":"2025082707362716000_14.8.e244479.8","first-page":"333","article-title":"The clinical spectrum of remitting seronegative symmetrical synovitis with pitting edema. The Catal\u00e1n group for the study of RS3PE","volume":"24","author":"Oliv\u00e9","year":"1997","journal-title":"J Rheumatol"},{"key":"2025082707362716000_14.8.e244479.9","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3390\/vaccines9050435","article-title":"Immune-Mediated disease flares or new-onset disease in 27 subjects following mRNA\/DNA SARS-CoV-2 vaccination","volume":"9","author":"Watad","year":"2021","journal-title":"Vaccines"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:36:35Z","timestamp":1756305395000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,4]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bcr-2021-244479"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244479","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}