Study of Demographic, Clinical and Laboratory Characteristics of Palindromic Rheumatism and Its Frequency in Comparison with Other Inflammatory Arthritis in North West of Iran

As no report is available in Iran regarding palindromic rheumatism, the aim of the present study was to investigate the frequency, demographic, clinical, and laboratory characteristics of palindromic rheumatism in North West of Iran. In this prospective study, patients with recurrent arthritis were visited by a rheumatologist. Diagnosis of palindromic rheumatism was made after ruling out other causes of recurrent arthritis such as crystal arthropathy, seronegative spondyloarthropathies, Behçet’s disease, etc. In addition, Pasero and Barbieri criteria were applied in order to diagnose the palindromic rheumatism. Subsequently, the patients were followed up for at least one year. Of 1225 patients with inflammatory arthritis, 34 (2.8%) patients were diagnosed as palindromic rheumatism. The rate of palindromic rheumatism to rheumatoid arthritis was 5.9%. The mean duration between the first episode of arthritis and diagnosis was 4.7 years. More than half of the patients (58%) had their first symptoms between the ages of 20 and 45. Male to female ratio was 1.8:1. Attacks were monoarthritic or oligoarthritic in 33 (97.1%) patients. The most involved joints were knees and hand proximal interphalangeal joints. Duration of attacks was more than 5 days in only two patients. Rheumatoid factor, anti-cyclic citrullinated peptide antibody (anti-CCP), and ANA were positive in 13 (37%), 20 (57%), and 3 (13.7%) patients, respectively. Demographic, clinical and laboratory characteristics of our patients with palindromic rheumatism are different in comparison with those of similar studies from other countries.