49. Schnitzler Syndrome: a Case of Chronic Urticaria and Monoclonal Gammopathy
Rheumatology advances in practice（2018）
摘要
common site of pathology, with decreasing incidence at the distal extremityofthelowerlimb.Inourcase,onlythefootandankleregionwas affected,withbothfeetbeingaffectedatdifferentpointsoftime.Recurrenceofepisodeshavebeendescribedintheliterature,andcan affectdifferentanatomicalsites.Thiswasthecaseforourpatient,butspecificallyaffectedthedistallimboneachoccasionratherthanmore commonproximalsites.Episodeshadbeenrelativelyfrequentalsoinourpatient,withmultipleepisodesoverthepreceding1tenyears-whichalso appearstobeanatypicalphenomenon.Duetothelocationofsymptomsatthepatient’sfeet,herrecurrentepisodeshadbeenessentiallymisdiag-nosedasprolongedgoutflares,thusleadingtodelayeddiagnosis.Unfortunately,basedontheliterature,thisisamorecommonexperience inpatientswithfootinvolvementduetoitslowerfrequencyandnon-specificnature.Assuch,patientsareatriskofpersistentbonepainsymp-tomswhichcanaffectfunctionandsubsequentqualityoflife. Key LearningPoints: Bone marrow oedemasyndromeisarare condi-tionthatcanoftenbemissed.Symptomscanbetransientinnaturewith patientsnotpresenting,orbeingmisdiagnosedwithalternativecondi-tions.Inourdescribedcase,thepatient’sepisodewasprolongedthus allowingappropriateinvestigation.Casesaregenerallymanagedcon-servatively,howevergradualresolutioncantakeweekstomonthsto occur.Literatureislimitedinregardingmedicaltherapy,howeveruseofbisphosphonateshasbeendescribedandwasutilisedinthiscase.Our
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