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Case Reports: Rare disease
Schnitzler syndrome
  1. Parvathy Ravi Sankar1,
  2. Varalakshmi Janamanchi2,
  3. Jaime Vondenberg1 and
  4. Cassandra Calabrese1
  1. 1Cleveland Clinic Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
  2. 2Hospital Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
  1. Correspondence to Dr Parvathy Ravi Sankar; sankarp2{at}ccf.org

Abstract

A woman in her late 40s with a history of psoriatic arthritis presented to us with fever, migratory rash, cervical and axillary lymphadenopathy, and generalised myalgia. Her symptoms did not improve with steroids and her inflammatory markers were in the range of 2000 mg/dL for C-reactive protein, erythrocyte sedimentation rate of 71 mm/hour and ferritin of 4000 ng/mL. Infectious workup was negative. Haematological malignancy and autoimmune conditions were among the top differentials, and she was eventually diagnosed with Schnitzler syndrome. A multidisciplinary team consisting of internal medicine, rheumatology, infectious disease and haematology-oncology specialists was involved in the care of this patient. We highlight the diagnostic schema that was followed for this rare and unique constellation of symptoms.

  • Immunology
  • Rheumatology

https://doi.org/10.1136/bcr-2022-254334

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    Footnotes

    • Correction notice The article has been corrected since it was first published online. Units of measurements were corrected.

    • Contributors PRS—responsible for the preliminary draft. VJ—edited the preliminary draft and added additional information. JV—edited and added to the original manuscript by creating a coherent story, collected the pictures. CC—reviewed and edited the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.