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Case Reports
. 2023 May 18;16(5):e254334.
doi: 10.1136/bcr-2022-254334.

Schnitzler syndrome

Parvathy Ravi Sankar  1 , Varalakshmi Janamanchi  2 , Jaime Vondenberg  3 , Cassandra Calabrese  3
Affiliations
Case Reports

Schnitzler syndrome

Parvathy Ravi Sankar et al. BMJ Case Rep. .

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 200 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.

Keywords: Immunology; Rheumatology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
The rash was maculopapular and appearance in her arms.
Figure 2
Figure 2
The maculopapular rash as seen in thigh with the skin biopsy site marked A.
Figure 3
Figure 3
Diffuse cervical lymphadenopathy seen in this patient with Schnitzler syndrome on her CT neck.
Figure 4
Figure 4
Pictorial representation of the different investigations pursued.
See this image and copyright information in PMC

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