Aseptic Abscess Syndrome in a Patient with Rheumatoid Arthritis: A Case Report
DOI:
https://doi.org/10.17533/udea.iatreia.231Keywords:
Arthritis, Rheumatoid, Abscess, Fever, Hereditary Autoinflammatory DiseasesAbstract
Aseptic abscess syndrome is a rare and possibly underdiagnosed condition characterized by the presence of sterile neutrophilic collections in various tissues that do not respond to antimicrobial therapy but rather require anti-inflammatory treatment. There is limited literature linking this condition to rheumatoid arthritis. Here, we present the case of a patient with rheumatoid arthritis, presenting with prolonged febrile síndrome and multiple sterile abscesses. A diagnosis of aseptic abscess síndrome was made, and successful resolution of the abscesses was achieved following treatment with glucocorticoid pulses and infliximab. Clinicians should consider this condition in patients with inflammatory diseases who develop abscesses in different tissues where no causative microbiological agent can be identified.
Downloads
References
(1) André MFJ, Piette JC, Kémény JL, Ninet J, Jego P, Delèvaux I, et al. Aseptic Abscesses: A Study of 30 Patients With or Without Inflammatory Bowel Disease and Review of the Literature. Medicine (Baltimore) [Internet]. 2007 May;86(3):145–61. Disponible en: https://pubmed.ncbi.nlm.nih.gov/17505254/
(2) Fillman H, Riquelme P, Sullivan PD, Mansoor AM. Aseptic abscess syndrome. BMJ Case Rep [Internet]. 2020 Oct;13(10):e236437. https://doi.org/10.1136/bcr-2020-236437
(3) Marzano AV, Borghi A, Stadnicki A, Crosti C, Cugno M. Cutaneous Manifestations in Patients With Inflammatory Bowel Diseases: Pathophysiology, Clinical Features, and Therapy. Inflamm Bowel Dis [Internet]. 2014 Jan;20(1):213–27. https://doi.org/10.1097/01.MIB.0000436959.62286.f9
(4) Elessa D, Thietart S, Corpechot C, Fain O, Mekinian A. TNF-α antagonist infliximab for aseptic abscess syndrome. Presse Médicale [Internet]. 2019 Dec;48(12):1579–80. https://doi.org/10.1016/j.lpm.2019.09.056
(5) Ito T, Sato N, Yamazaki H, Koike T, Emura I, Saeki T. A case of aseptic abscesses syndrome treated with corticosteroids and TNF-alpha blockade. Mod Rheumatol [Internet]. 2013 Jan;23(1):195–9. https://doi.org/10.1007/s10165-012-0640-y
(6) Isik M, Çalgüneri M, Doğan İ, Yeşilkaya Y, Shourbagi A. Aseptic Abscess: A Report of Two Cases. Eur J Inflamm [Internet]. 2012 Jan;10(1):143–7. https://doi.org/10.1177/1721727x1201000119
(7) Hastier P, Caroli-Bosc FX, Bartel HR, Harris AG, Maes B, Arpurt JP, et al. Pyoderma gangrenosum with hepatopancreatic manifestations in a patient with rheumatoid arthritis. Dig Dis Sci [Internet]. 1996 Mar;41(3):594–7. https://doi.org/10.1007/BF02282347
(8) Fukuhara, Urano, Kimura, Hori, Arase S. Pyoderma gangrenosum with rheumatoid arthritis and pulmonary aseptic abscess responding to treatment with dapsone. Br J Dermatol [Internet]. 1998 Sep;139(3):556–8. https://doi.org/10.1046/j.1365-2133.1998.02440.x
(9) Weins AB, Scharffetter‐Kochanek K, Weiss T, Crisan D, Hehl N, Weiss J, et al. Successful targeted cytokine blockade in a case of aseptic abscess syndrome. JDDG J Dtsch Dermatol Ges [Internet]. 2020 Aug;18(8):908–10. https://doi.org/10.1111/ddg.14147
(10) Agirgol S, Ustaoglu E, Demir F, Akbulut T, Turkoglu Z, Kaya H, et al. Aseptic Abscess Syndrome with Severe Skin Involvement: Case Report. Indian J Dermatol [Internet]. 2020;65(5):434-36. https://doi.org/10.4103/ijd.IJD_259_18
(11) Bardy A, Guettrot-Imbert G, Aumaître O, André MFJ. Efficacy of Il-1β blockade in refractory aseptic abscesses syndrome. Mod Rheumatol [Internet]. 2014 Jan;24(1):217–9. https://doi.org/10.3109/14397595.2013.852835
(12) Bollegala N, Khan R, Scaffidi MA, Al-Mazroui A, Tessolini J, Showler A, et al. Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature. Can J Gastroenterol Hepatol [Internet]. 2017;2017:1–8. https://doi.org/10.1155/2017/5124354
(13) Doll R, Friedman K, Hostoffer R. Aseptic Abscess Syndrome, a Case of Prolonged Remission Following Splenectomy. Am J Gastroenterol [Internet]. 2018 Aug;113(8):1264–5. https://doi.org/10.1038/s41395-018-0163-z
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Iatreia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Papers published in the journal are available for use under the Creative Commons license, specifically Attribution-NonCommercial-ShareAlike 4.0 International.
The papers must be unpublished and sent exclusively to the Journal Iatreia; the author uploading the contribution is required to submit two fully completed formats: article submission and authorship responsibility.
