TY  - CHAP
M1  - Book, Section
TI  - Rheumatologic Manifestations of Cancer
A1  - Hellmann, David B.
A1  - Imboden Jr., John B.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
PY  - 2020
T2  - Current Medical Diagnosis and Treatment 2020
AB  - Rheumatologic  syndromes  may  be  the  presenting  manifestations  for  a  variety  of  cancers  (see  eTable  39–1).  Dermatomyositis  in  adults,  for  example,  is  often  associated  with  cancer.  Hypertrophic  pulmonary  osteoarthropathy,  which  is  characterized  by  the  triad  of  polyarthritis,  new  onset  of  clubbing,  and  periosteal  new  bone  formation,  is  associated  with  both  malignant  diseases  (eg,  lung  and  intrathoracic  cancers)  and  nonmalignant  ones  (eg,  cyanotic  heart  disease,  cirrhosis,  and  lung  abscess).  Cancer-associated  polyarthritis  is  rare,  has  both  oligoarticular  and  polyarticular  forms,  and  should  be  considered  when  “seronegative  rheumatoid  arthritis”  develops  abruptly  in  an  elderly  patient.  Palmar  fasciitis  manifests  as  bilateral  palmar  swelling  with  finger  contractures  and  may  be  the  first  indication  of  cancer,  particularly  ovarian  carcinoma.  Remitting  seronegative  synovitis  with  non-pitting  edema  (“RS3PE”)  presents  with  a  symmetric  small-joint  polyarthritis  associated  with  non-pitting  edema  of  the  hands;  it  can  be  idiopathic  or  associated  with  malignancy.  Palpable  purpura  due  to  leukocytoclastic  vasculitis  may  be  the  presenting  complaint  in  myeloproliferative  disorders.  Hairy  cell  leukemia  can  be  associated  with  medium-sized  vessel  vasculitis  such  as  polyarteritis  nodosa.  Acute  leukemia  can  produce  joint  pains  that  are  disproportionately  severe  in  comparison  to  the  minimal  swelling  and  heat  that  are  present.  Leukemic  arthritis  complicates  approximately  5%  of  cases.  Rheumatic  manifestations  of  myelodysplastic  syndromes  include  cutaneous  vasculitis,  lupus-like  syndromes,  neuropathy,  and  episodic  intense  arthritis.  Erythromelalgia,  a  painful  warmth  and  redness  of  the  extremities  that  (unlike  Raynaud)  improves  with  cold  exposure  or  with  elevation  of  the  extremity,  is  often  associated  with  myeloproliferative  diseases,  particularly  essential  thrombocythemia.  The  discovery  that  the  immune  response  to  various  neoplasms  can  cause  scleroderma,  at  least  in  a  few  patients,  suggests  the  possibility  that  many  autoimmune  disorders  may  be  caused  by  cancer  immune  surveillance.  Cancer  therapies,  especially  selective  estrogen  receptor  modulators,  aromatase  inhibitors,  and  immune  checkpoint  inhibitors,  can  cause  myalgia,  arthralgia,  arthritis,  and  autoimmune  disorders.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2022/05/21
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1166169826
ER  -