Clinical Rheumatology

, Volume 6, Issue 3, pp 439–445 | Cite as

The coexistence of rheumatoid arthritis and systemic lupus erythematosus

  • C. Venegoni
  • M. Chevallard
  • G. Mele
  • G. Banfi
  • M. Carrabba
Case Report

Summary

A 29-year-old white female with longstanding classical rheumatoid arthritis (RA) developed clinical and serological manifestations of systemic lupus erythematosus (SLE) with prominent signs of diffuse proliferative lupus nephritis. She fulfilled the ARA criteria for the classification of SLE as well as the ARA criteria for classical RA. The concomitant presence of these two affections in the same patient is rare and the discriminating features suggest that this coexistence may be coincidental. With respect to treatment, our patient had good relief of symptoms by a combined administration of methylprednisolone pulses and cyclophosphamide.

Key words

Rheumatoid Arthritis Systemic Lupus Erythematosus Lupus Nephritis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Toone, E., Irby, R., Pierce, E.L. The LE cell in rheumatoid arthritis. Am J Med Sci 1960, 240, 599–608.Google Scholar
  2. 2.
    Dubois, E.L. The relationship between SLE and RA. In: Lupus Erythematosus, Los Angeles, University of Southern California Press, 1976, 293–301.Google Scholar
  3. 3.
    Kantor, G.L., Byckel, Y.B., Barnett, V. Coexistence of systemic lupus erythematosus and rheumatoid arthritis. Am J Med 1969, 47, 433–444.Google Scholar
  4. 4.
    Hahn, B.H., Yardley, J.H., Stevens, M.B. “Rheumatoid” nodules in systemic lupus erythematosus. Ann Intern Med 1970, 72, 49–58.Google Scholar
  5. 5.
    Fischman, A.S., Abeles, M., Zanetti, M., Weinstein, A., Rothfield, N.F., The coexistence of rheumatoid arthritis and systemic lupus erythematosus: a case report and review of the literature. J Rheumatol 1982, 8, 405–415.Google Scholar
  6. 6.
    Cohen, M.G., Webb, J. RA onset and subsequent SLE overlap syndromes. XVI International Congress of Rheumatology, Sydney, 19–25 May 1985, P 678 (abstract).Google Scholar
  7. 7.
    Tan, E.M., Cohen, A.S., Fries, J.F., Masi, A.T., McShane, D.J., Rothfield, N.F., Schaller, J.G., Talal, N., Winchester, R.J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982, 25, 1271–1277.Google Scholar
  8. 8.
    Ropes, M.W., Bennett, G.A., Cobb, S., Jacox, R.F., Jessar, R.A. 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 1958, 9, 175–176.Google Scholar
  9. 9.
    Kievitz, J.H., Goslings, J., Schiut, H.R.E., Hijmans W. Rheumatoid arthritis and the positive LE cell phenomena. Ann Rheum Dis 1956, 15, 211–216.Google Scholar
  10. 10.
    Ross, S.W., Clardy, E.K. The LE test in patients presenting the clinical picture of rheumatoid arthritis. Southern Med J 1956, 49, 553–559.Google Scholar
  11. 11.
    Hazeovet, H.N., Hijmans, W., Kievitz, J.H. Significance of the LE cell phenomenon for the symptomatology and prognosis of rheumatoid arthritis: a follow-up study of 9 years. Ann Rheum Dis 1966, 25, 375–376, (abstract).Google Scholar
  12. 12.
    Dubeyre, N., Kahn, M.F., Ryckewaert, A., De Seze, S. Rheumatoid arthritis with Hargraves (LE cells). Presse Med 1966, 74, 911–913.Google Scholar
  13. 13.
    Elling, P. On the incidence of antinuclear factors in rheumatoid arthritis. Acta Rheum Scand 1970, 13, 101–112.Google Scholar
  14. 14.
    Linn, J.E., Hardin, J.G., Halla, J.T. A controlled study of ANA+ and RF− arthritis. Arthritis Rheum 1978, 21, 645–651.Google Scholar
  15. 15.
    Hughes, G., Rothfield, N.F. Serum antinuclear antibodies in rheumatoid arthritis. Conn Med 1970, 34, 171–176.Google Scholar
  16. 16.
    Pollack, V.E., Pirani, C.L., Steck, I.E., Karl, R.M. The kidney in rheumatoid arthritis: studies by renal biopsy. Arthritis Rheum 1962, 5, 1–8.Google Scholar
  17. 17.
    Brun, C., Olsen, T.S., Raaschou, E., Sorensen, A.W.S. Renal biopsy in rheumatoid arthritis. Nephron 1965, 2, 65–81.Google Scholar
  18. 18.
    Salomon, M.I., Gallo, G., Poon, T.P., Goldblat, W.V., Tchertkoff, V. The kidney in rheumatoid arthritis: a study based on renal biopsies. Nephron 1974, 12, 297–310.Google Scholar
  19. 19.
    Davis, J.A., Cohen, A.H., Weisbart, R., Paulus, H.E. Glomerulonephritis in rheumatoid arthritis. Arthritis Rheum, 1979, 22, 1018–1023.Google Scholar
  20. 20.
    Skrifvars, B. Immunofluorescence study of renal biopsies in chronic rheumatoid arthritis. Scand J Rheumatol 1979, 8, 241–247.Google Scholar
  21. 21.
    Friedman, R., Gallo, G.R., Buxman, J.N. Renal disease in rheumatoid arthritis. Arthritis Rheum 1980, 23, 781–783.Google Scholar
  22. 22.
    Adu, D., Cameron, J.S. Lupus nephritis. Clin Rheum Dis 1982, 8, 153–182.Google Scholar
  23. 23.
    Ivanova, M.M., Nesgorova, L.I., Mylov, N.M., Nassonova, V.A. Lupus nephritis. Scand J Rheumatol 1984 Suppl. 52, 82–85.Google Scholar
  24. 24.
    Silverberg, D.S., Kidd, E.G., Shnitka, T.H., Ulan R.A. Gold nephropathy: a clinical and pathological study. Arthritis Rheum 1970, 13, 812–825.Google Scholar
  25. 25.
    Samuels, B., Lee, J.C., Engleman, E.P., Hopper, J.Jr. Membranous nephropathy in patients with rheumatoid arthritis: relationship to gold therapy. Medicine 1977, 57, 319–327.Google Scholar
  26. 26.
    Chevallard, M., Venegoni, C., Carrabba, M. La nefropatia aurica in corso di artrite reumatoide: contributo casistico. Arch Ortop Reumatol 1984, 97, 233–240.Google Scholar
  27. 27.
    Stastny, P. Association of the B cell alloantigen DRW4 with rheumatoid arthritis. N Engl J Med 1978, 298, 869–871.Google Scholar
  28. 28.
    Reinertsen, J.L., Klippel, J.H., Johnson, A.H., Steinberg, A.D., Decker, J.L., Mann, D.L. B lymphocyte alloantigens associated with systemic lupus erythematosus. N Engl J Med 1978, 299, 515–518.Google Scholar
  29. 29.
    Gibofsky, A., Winchester, R., Hansen, J., Patarroyo, M., Dupont, B., Paget, S., Lahita, R., Halper, J., Fotino, M., Yunis, E., Kunkel, H.G. Contrasting patterns of newer istocompatibility determinants in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Rheum 1978, 21 (Suppl.), 134–138.Google Scholar
  30. 30.
    Donadio, J.V., Molley, K.E., Ferguson, R.H., Ilstrump, D.H. Treatment of diffuse proliferative lupus nephritis with prednisone and combined prednisone and cyclophosphamide. New Engl J Med 1978, 299, 1151–1157.Google Scholar
  31. 31.
    Ponticelli, C., Zucchelli, P., Banfi, G., Cagnoli, I., Scalia, P., Pasquali, S., Imbasciati, E. Treatment of diffuse proliferative lupus nephritis by intravenous high-dose methylprednisolone. Q J Med 1982, 201, 16–24.Google Scholar
  32. 32.
    Hoch, S., Schur, P.H. Methylprednisolone pulse therapy for lupus nephritis: a follow-up study. Clin Exp Rheumatol 1984, 2, 313–320.Google Scholar

Copyright information

© Acta Medica Belgica 1987

Authors and Affiliations

  • C. Venegoni
    • 1
  • M. Chevallard
    • 1
  • G. Mele
    • 1
  • G. Banfi
    • 2
  • M. Carrabba
    • 1
  1. 1.Department of RheumatologyUniversity of Milan, G. Pini Orthopaedic InstituteMilanItaly
  2. 2.Division of Nephrology and DialysisMaggiore Policlinico HospitalMilanItaly

Personalised recommendations