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Unravelling the NERDS syndrome
  1. Achintya Dinesh Singh1,
  2. Tejas Menon Suri2,
  3. Rakesh Kumar Jagdish3,
  4. Uma Kumar4
  1. 1Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of Pulmonary Medicine Critical Care, All India Institute of Medical Sciences, New Delhi, India
  3. 3Gastroenterology, Institute of Liver and Biliary Sciences, New Delhi, India
  4. 4Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Uma Kumar, umaakumar{at}


A 22-year-old man presented with symmetric polyarthritis, pruritus and deviation of angle of mouth to the right side since the last 7 years. His symptoms were persistent despite receiving ayurvedic medications and symptomatic therapy. Examination revealed dry skin, cutaneous nodules, xanthelasma, periarticular non-tender swellings, pitting oedema of hands and feet and lower motor neuron type right facial palsy. Haematological investigations revealed eosinophilia and skin biopsy had cutaneous eosinophilic infiltration. The constellation of above findings comprises the nodules, eosinophilia, rheumatism, dermatitis and swelling syndrome. It a rare syndrome with few reported cases in literature. The patient was started on oral corticosteroids which was subsequently tapered and methotrexate therapy. His polyarthritis and skin rashes resolved with therapy. He has been followed-up for 2 years and is presently asymptomatic for the last 1 year.

  • rheumatology
  • connective tissue disease
  • dermatology
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  • Contributors ADS and TMS were directly involved in the management of the case. RKJ was involved in the diagnosis and management of the case. UK was the supervising head and in charge of the case. All the authors contributed equally in the writing of the 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.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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