Impact of low-dose prednisolone on refractory pitting edema manifesting remitting seronegative symmetrical synovitis with pitting edema syndrome Yuhei.

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Impact of low-dose prednisolone on refractory pitting edema manifesting remitting seronegative symmetrical synovitis with pitting edema syndrome Yuhei Nojima, MD, Madoka Ihara, MD, PhD, Hidenori Adachi, MD, Tetsuya Kurimoto, MD, PhD, Shinsuke Nanto, MD, PhD, FJCC Journal of Cardiology Cases Volume 14, Issue 4, Pages 119-122 (October 2016) DOI: 10.1016/j.jccase.2016.06.006 Copyright © 2016 Japanese College of Cardiology Terms and Conditions

Fig. 1 (A) Image of elderly male patient's swollen, reddened lower legs and joints with markedly pitting edema. (B) Otherwise, pitting edema was not detected in both his hands at admission. (C) Photograph of the lower legs and joints of the same elderly male patient as in (A) after taking low-dose prednisolone for 5 days to ameliorate refractory pitting edema. Journal of Cardiology Cases 2016 14, 119-122DOI: (10.1016/j.jccase.2016.06.006) Copyright © 2016 Japanese College of Cardiology Terms and Conditions

Fig. 2 Transthoracic echocardiogram. (A and B) Parasternal short-axis view in diastole and systole phase showing good left ventricular contraction and opening of the mitral valve. (C) The maximum size of the inferior vena cava was 15cm and the minimum size of 8cm with respiratory change. (D) Mild tricuspid regurgitation was observed. The pressure gradient through the tricuspid valve was 22mmHg. Journal of Cardiology Cases 2016 14, 119-122DOI: (10.1016/j.jccase.2016.06.006) Copyright © 2016 Japanese College of Cardiology Terms and Conditions

Fig. 3 Anteroposterior chest X-ray showed enlargement of bilateral pulmonary arteries without pulmonary congestion. The angle in the bronchial bifurcation was wide open. These findings implied bi-atrial enlargement. Journal of Cardiology Cases 2016 14, 119-122DOI: (10.1016/j.jccase.2016.06.006) Copyright © 2016 Japanese College of Cardiology Terms and Conditions