Fibroblastic rheumatism: the first case with infiltration of multinuclear giant cells and raised blood lead level

Fibroblastic rheumatism (FR) is a rare condition characterized by symmetrical polyarthritis and multiple cutaneous nodules. Approximately 30 cases have been reported worldwide to date. Laboratory tests are not particular useful to confirm the disease. Diagnosis is mainly dependent on the characteristic histopathological features: thickened collagen fibres with spindle-shaped cell proliferation in the skin lesion. We report a case of a 48-year-old Chinese man with typical clinical features of FR. In addition to the characteristic histopathological findings, multinuclear giant cell infiltration in skin lesions was detected, in this case. The evaluation of microelements revealed a raised blood lead level) of 129 μg/L (normal range 0-99 μg/L) These two features have never been described in the previous medical literature on FR. Thus, we propose that examining the infiltrated cells in detail in histopathological studies and inspecting the levels of lead and other microelements in the blood may increase our understanding of the pathogenesis of FR.