{"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":1782603958208,"version":"3.54.5"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is characterized by symmetrical polyarthritis and limb pitting edema. Although the detailed mechanisms of this syndrome have not been clearly understood, some agents including dipeptidyl peptidase-4 inhibitors have been reported to induce RS3PE syndrome. However, glucagon-like peptide-1 (GLP-1) analogues have not been reported to be associated with this syndrome. A 91-year-old woman was admitted to our hospital with complaints of severe polyarthritis and limb edema. She was diagnosed with RS3PE syndrome. Oral prednisolone improved her symptoms. However, her symptoms worsened after the administration of dulaglutide, with elevated serum inflammatory markers. Discontinuation of dulaglutide without additional treatment improved her symptoms and laboratory findings. This case might indicate the possibility of development and worsening of RS3PE syndrome caused after GLP-1 analogue.<\/jats:p>","DOI":"10.3390\/medicina58020289","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T20:58:03Z","timestamp":1644872283000},"page":"289","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Worsen after the Administration of Dulaglutide"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1279-4947","authenticated-orcid":false,"given":"Toshitaka","family":"Sawamura","sequence":"first","affiliation":[{"name":"Asanogawa General Hospital, 83 Kosakamachi, Kanazawa 910-8621, Japan"},{"name":"Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigehiro","family":"Karashima","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Ohmori","sequence":"additional","affiliation":[{"name":"Asanogawa General Hospital, 83 Kosakamachi, Kanazawa 910-8621, Japan"},{"name":"Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Sawada","sequence":"additional","affiliation":[{"name":"Asanogawa General Hospital, 83 Kosakamachi, Kanazawa 910-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Kometani","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan"},{"name":"Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyu","family":"Takeda","sequence":"additional","affiliation":[{"name":"Asanogawa General Hospital, 83 Kosakamachi, Kanazawa 910-8621, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-158X","authenticated-orcid":false,"given":"Takashi","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan"},{"name":"Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"ref_1","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":"Pons","year":"1997","journal-title":"J. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.2337\/dc11-1995","article-title":"RS3PE Association with Dipeptidyl Pep-tidase-4 Inhibitor: Report of Two Cases","volume":"35","author":"Yamauchi","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.semarthrit.2008.11.006","article-title":"Is remitting seronegative symmetrical synovitis with pitting edema (RS3PE) a subset of rheumatoid arthritis?","volume":"40","author":"Yao","year":"2010","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"119","DOI":"10.12659\/AJCR.890318","article-title":"Novel Development of Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) Syndrome due to Insulin Therapy","volume":"15","author":"George","year":"2014","journal-title":"Am. J. Case Rep."},{"key":"ref_5","unstructured":"World Health Organization (WHO)-Uppsala Monitoring Centre (2022, January 10). The Use of the WHO-UMC System for Standardized Case Causality Assessment. Available online: http:\/\/www.who-umc.org\/Graphics\/24734.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.2337\/dc10-0187","article-title":"The oral dipeptidyl peptidase-4 inhibitor sitagliptin increases circulating endothelial progenitor cells in patients with type 2 diabetes: Possible role of stromal-derived factor-1alpha","volume":"33","author":"Fadini","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1046\/j.1365-2184.2003.00262.x","article-title":"Stromal cell-derived factor 1\u03b1 (SDF-1\u03b1) induces gene-expression of early growth response-1 (Egr-1) and VEGF in human arterial endothelial cells and enhances VEGF induced cell proliferation","volume":"36","author":"Neuhaus","year":"2003","journal-title":"Cell Prolif."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1136\/ard.2004.032995","article-title":"RS3PE syndrome presenting as vascular endothelial growth factor associated disorder","volume":"64","author":"Arima","year":"2005","journal-title":"Ann. Rheum. Dis."},{"key":"ref_9","first-page":"BR35","article-title":"Glucagon-like Peptide-1 improves proliferation and differentiation of endothelial progenitor cells via upregulating VEGF generation","volume":"17","author":"Xie","year":"2011","journal-title":"Med. Sci. Monit."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21513","DOI":"10.3390\/ijms141121513","article-title":"Neuroprotective Effects of Liraglutide for Stroke Model of Rats","volume":"14","author":"Sato","year":"2013","journal-title":"Int. J. Mol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1161\/hc0302.102143","article-title":"Decreased cardiac expression of vascular endothelial growth factor and its receptors in insulin-resistant and diabetic States: A possible explanation for impaired collateral formation in cardiac tissue","volume":"105","author":"Chou","year":"2002","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"F182","DOI":"10.1152\/ajprenal.00548.2012","article-title":"Insulin directly stimulates VEGF-A production in the glomerular podocyte","volume":"305","author":"Hale","year":"2013","journal-title":"Am. J. Physiol. Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e0415","DOI":"10.1097\/MD.0000000000010415","article-title":"VEGF levels in plasma in relation to metabolic control, inflammation, and microvascular complications in type-2 diabetes: A cohort study","volume":"97","author":"Zhang","year":"2018","journal-title":"Medicine"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/289\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:19:27Z","timestamp":1760134767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,14]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["medicina58020289"],"URL":"https:\/\/doi.org\/10.3390\/medicina58020289","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,14]]}}}