[Fibroblastic rheumatism: a case report].

Abstract

UNLABELLED: Fibroblastic rheumatism is a rare entity. Nineteen cases were reported in the literature, and among them, only one in a child. CASE REPORT: Cam. (born August 19, 1988) had an onset of disease in October 1996 with nodules on the MCP and PIP, elbows and tibia, with partial improvement after three months. In April 1997, she suffered from arthralgia and stiffness of both wrists, and then of the big toes. X-rays showed destructive and erosive lesions on both wrists and on the PIP of the second and third fingers and the big toes. Laboratory investigations disclosed normal values for ESR and CRP and negative results for ANA and RF. The diagnosis of fibroblastic rheumatism was based on the typical histologic pattern of a nodule. The treatment associated colchicin and rehabilitation. In August 1998, the wrists' stiffness began to improve, though the big toes remained totally stiff. The radiologic erosive lesions did not show progress. COMMENTS: The diagnosis of fibroblastic rheumatism is based on the histologic pattern of the nodules. The erosive evolution of the arthropathies is infrequent (8/15 cases in adults). Juvenile onset is very rare; only one case has been reported, in a 10-year-old boy. The mechanism of the disease remains unknown. As it is very rare, the therapeutic strategies are not well established. CONCLUSION: This disease should be considered among the causes of juvenile arthritis with erosion.