Multicentric Reticulohistiocytosis mimicking seronegative rheumatoid arthritis: a case report of destructive erosive arthritis with partial response to Upadacitinib.
- 1McGovern Medical School at UTHealth Houston, Department of Diagnostic and Interventional Imaging, 6431 Fannin St, Houston, TX 77030, United States.
- 2King's College London, Guy's, King's and St Thomas' School of Medicine, Guy's Campus, Great Maze Pond, London SE1 1UL, United Kingdom.
- 3The London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare non-Langerhans cell histiocytosis that can mimic seronegative rheumatoid arthritis through destructive inflammatory arthritis and papulonodular skin lesions. We report a 44-year-old woman with progressive polyarthritis, purplish papulonodular lesions and destructive erosive disease of the hands and feet. Rheumatoid factor, anti-cyclic citrullinated peptide antibody and antinuclear antibody were negative. Radiographs showed sharply demarcated erosions with prominent distal interphalangeal involvement, and skin biopsy confirmed MRH. Available malignancy screening, including oncology review, mammography, cervical screening and blood tests, was reassuring, although planned PET-CT was not completed due to loss to follow-up. Methotrexate and corticosteroids were not tolerated, certolizumab produced partial response, and upadacitinib led to modest cutaneous improvement but persistent active synovitis at four months. This case highlights MRH as a diagnostic mimic of seronegative rheumatoid arthritis and illustrates discordant treatment response to JAK inhibition.
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BibTeX
@article{sadiq2026multicentric,
title = {{Multicentric Reticulohistiocytosis mimicking seronegative rheumatoid arthritis: a case report of destructive erosive arthritis with partial response to Upadacitinib.}},
author = {Muhayman Sadiq and Omar Ba-Abbad and James Galloway and Ernest Fonocho},
journal = {Oxford medical case reports},
year = {2026},
month = oct,
doi = {10.1093/omcr/omag174},
url = {https://europepmc.org/article/MED/42928780},
note = {CC BY},
}
RIS
TY - JOUR
TI - Multicentric Reticulohistiocytosis mimicking seronegative rheumatoid arthritis: a case report of destructive erosive arthritis with partial response to Upadacitinib.
AU - Muhayman Sadiq
AU - Omar Ba-Abbad
AU - James Galloway
AU - Ernest Fonocho
PY - 2026
DA - 2026/10/25
JO - Oxford medical case reports
DO - 10.1093/omcr/omag174
UR - https://europepmc.org/article/MED/42928780
AB - Multicentric reticulohistiocytosis (MRH) is a rare non-Langerhans cell histiocytosis that can mimic seronegative rheumatoid arthritis through destructive inflammatory arthritis and papulonodular skin lesions. We report a 44-year-old woman with progressive polyarthritis, purplish papulonodular lesions and destructive erosive disease of the hands and feet. Rheumatoid factor, anti-cyclic citrullinated peptide antibody and antinuclear antibody were negative. Radiographs showed sharply demarcated erosions with prominent distal interphalangeal involvement, and skin biopsy confirmed MRH. Available malignancy screening, including oncology review, mammography, cervical screening and blood tests, was reassuring, although planned PET-CT was not completed due to loss to follow-up. Methotrexate and corticosteroids were not tolerated, certolizumab produced partial response, and upadacitinib led to modest cutaneous improvement but persistent active synovitis at four months. This case highlights MRH as a diagnostic mimic of seronegative rheumatoid arthritis and illustrates discordant treatment response to JAK inhibition.
SN - 2053-8855
ER -