Rheumatology International

, Volume 31, Issue 1, pp 49–52

Valvular heart disease in systemic lupus erythematosus and Jaccoud’s arthropathy

  • Mittermayer B. Santiago
  • Stella M. M. Dourado
  • Natália O. Silva
  • Marina P. Motta
  • Lara S. B. Grimaldi
  • Vinicius R. Rios
  • Verena Galvão
Original Article

Abstract

Jaccoud’s arthropathy (JA) was initially described as a secondary complication to rheumatic fever (RF). However, most recently described cases are associated with systemic lupus erythematosus (SLE). At least in RF, this articular complication has been observed to occur in association with valvular heart disease. The aim of this work is to investigate the presence of valvulopathy in patients with SLE and JA, when compared to lupus patients without such complication. Patients with diagnosis of SLE based on the American College of Rheumatology criteria were enrolled in the study and divided into two groups: with or without JA and evaluated by transthoracic echocardiography. A total of 113 patients with SLE (25 with JA and 88 without JA) were assessed, of which 108 were females and five were males. Echocardiographic changes were found in 24 patients (21.2%) out of the entire population, including valvulopathy in 17 cases (15%), pulmonary hypertension in 7 cases (6.2%) and pericardial effusion in 2 cases (1.8%). In general, echocardiographic changes were more frequently seen in the JA group in comparison with the control group (p = 0.04). Additionally, in the JA group, valvulopathy was found in nine cases (36%) against eight cases (9%) in the control group (p = 0.001). This study reveals for the first time the association between the presence of valvular heart disease and JA in SLE patients, suggesting that the presence of JA may be a marker of such complication. Additional studies are required for clarification of the mechanisms involved in both complications.

Keywords

Systemic lupus erythematosus Rheumatic fever Jaccoud’s arthropathy Valvular heart disease 

Reference

  1. 1.
    Bywaters EG (1950) The relation between heart and joint disease including “rheumatoid heart disease” and chronic post rheumatic arthritis (type Jaccoud). Br Heart J 12(2):101–131CrossRefPubMedGoogle Scholar
  2. 2.
    Santiago MB, Galvao V (2008) Jaccoud arthropathy in systemic lupus erythematosus: analysis of clinical characteristics and review of the literature. Medicine (Baltimore) 87(1):37–44CrossRefGoogle Scholar
  3. 3.
    Paredes JG, Lazaro MA, Citera G, Da Representacao S, Maldonado Cocco JA (1997) Jaccoud’s arthropathy of the hands in overlap syndrome. Clin Rheumatol 16(1):65–69CrossRefPubMedGoogle Scholar
  4. 4.
    Whittaker R, Griffiths H (1993) Jaccoud’s arthropathy and hypermobility syndrome. J Rheumatol 20(9):1636PubMedGoogle Scholar
  5. 5.
    Babini SM, Cocco JA, de la Sota SM, Babini JC, Arturi A, Marcos JC et al (1989) Tendinous laxity and Jaccoud’s syndrome in patients with systemic lupus erythematosus. Possible role of secondary hyperparathyroidism. J Rheumatol 16(4):494–498PubMedGoogle Scholar
  6. 6.
    Ignaczak T, Espinoza LR, Kantor OS, Osterland CK (1975) Jaccoud arthritis. Arch Intern Med 135(4):577–579CrossRefPubMedGoogle Scholar
  7. 7.
    Houser SL, Askenase PW, Palazzo E, Bloch KJ (2002) Valvular heart disease in patients with hypocomplementemic urticarial vasculitis syndrome associated with Jaccoud’s arthropathy. Cardiovasc Pathol 11(4):210–216CrossRefPubMedGoogle Scholar
  8. 8.
    Chen HJ, Bloch KJ (2001) Hypocomplementemic urticarial vasculitis, Jaccoud’s arthropathy, valvular heart disease, and reversible tracheal stenosis: a surfeit of syndromes. J Rheumatol 28(2):383–386PubMedGoogle Scholar
  9. 9.
    Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25(11):1271–1277CrossRefPubMedGoogle Scholar
  10. 10.
    Galvao V, Atta AM, Sousa Atta ML, Motta M, Dourado S, Grimaldi L et al (2009) Profile of autoantibodies in Jaccoud’s arthropathy. Jt Bone Spine 76(4):356–360CrossRefGoogle Scholar
  11. 11.
    van Vugt RM, Derksen RH, Kater L, Bijlsma JW (1998) Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus. Ann Rheum Dis 57(9):540–544CrossRefPubMedGoogle Scholar
  12. 12.
    Khamashta MA, Cervera R, Asherson RA, Font J, Gil A, Coltart DJ et al (1990) Association of antibodies against phospholipids with heart valve disease in systemic lupus erythematosus. Lancet 335(8705):1541–1544CrossRefPubMedGoogle Scholar
  13. 13.
    Lincoln J, Lange AW, Yutzey KE (2006) Hearts and bones: shared regulatory mechanisms in heart valve, cartilage, tendon, and bone development. Dev Biol 294(2):292–302CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Mittermayer B. Santiago
    • 1
    • 2
  • Stella M. M. Dourado
    • 1
    • 2
  • Natália O. Silva
    • 1
    • 2
  • Marina P. Motta
    • 1
    • 2
  • Lara S. B. Grimaldi
    • 1
    • 2
  • Vinicius R. Rios
    • 2
  • Verena Galvão
    • 3
  1. 1.Escola Bahiana de Medicina e Saúde Pública (EBMSP)SalvadorBrazil
  2. 2.Rheumatology ServiceHospital Santa Izabel Salvador Brazil
  3. 3.Universidade Católica De Salvador Salvador Brazil

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