Palindromic rheumatism: effect of dietary manipulation.

March 1, 2002

Clin Exp Rheumatol 2000 May-Jun;18(3):375-8

Nesher G, Mates M.

Department of Intermal Medicine, Shaare-Zedek Medical Center, Jerusalem,

Israel. nesher@...

OBJECTIVE: Evaluation of the contribution of dietary components in

triggering the attacks of palindromic rheumatism (PR), and the effect of

dietary manipulation on the frequency and severity of PR attacks.

METHODS: Sixteen patients (10 males, 6 females) were diagnosed as having

PR during 1994-8 in one center. Their mean age was 45 +/- 6, duration of

symptoms prior to diagnosis was 4 +/- 1.4 years, and frequency of PR

attacks were 3.1 +/- 1.8/month. All patients were instructed to make a

list of the food that was consumed daily and to specify the dates of PR

episodes. Data were evaluated after a period of 2-4 months in each

patient. RESULTS: In 5 patients (31%) there was an association between

episodes of PR and certain foods that were consumed within 36 hours

prior to PR episodes. These were fish (2 patients), eggs, canned

vegetables and processed cheese (each in one case). Elimination of the

relevant food from each patient's diet resulted in complete cessation of

the PR attacks in two of the cases, while the other three had milder,

infrequent attacks. Four patients were rechallenged with the offending

food. In all cases it resulted in recurrence of the PR attacks. No

association between PR episodes and prior consumption of certain foods

could be documented in the other 11 patients. CONCLUSIONS: In some PR

patients ingestion of certain foods, specific for each case, can trigger

the typical attack. It is suggested that this association should be

looked for in any PR patient, as elimination of the offending food from

the diet may help in preventing the PR attacks.

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