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Lupus arthropathy: a case series of patients with rhupus

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Abstract

Among the clinical manifestations of systemic lupus erythematosus (SLE) is an arthropathy, which is usually nonerosive. In many cases the joint involvement is mild. A subset of patients have deforming, nonerosive Jaccoud’s arthropathy, and a minority have an arthropathy with clinical findings similar to rheumatoid arthritis (RA) that has been called “rhupus.” We report our series of eight patients (seven female, one male) with rhupus arthropathy. Patients were between the ages of 17 and 38 years (average: 30.3 years) at disease onset. All had deforming or Jaccoud∝s arthropathy, and three had erosive disease. The arthritis was typically the first disease manifestation. Other symptoms of lupus including vasculitis and glomerulonephritis appeared after an average of 2.8 years. All had positive antinuclear antibody and rheumatoid factor. Rhupus arthritis is not a combination of RA and SLE, but should be regarded as a variant of the arthropathy of lupus.

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References

  1. Cohen AS, Reynolds WE, Franklin EC, Kulka JP, Ropes MW, Shulman LE, Wallace SL (1971) Preliminary criteria for the classification of systemic lupus erythematosus. Bull Rheum Dis 21:643–648

    Google Scholar 

  2. Kaposi M (1892) Neue Beiträge zur Kenntnis des Lupus erythematosus. Arch Dermatol Syph 4:36–79

    Google Scholar 

  3. Keil H (1937) Conception of lupus erythematosus. Arch Dermatol 36:729–757

    Google Scholar 

  4. Bywaters EG (1975) Jaccoud’s syndrome: a sequel to the joint involvement of systemic lupus erythematosus. Clin Rheum Dis 1:125–148

    Google Scholar 

  5. Kramer LS, Ruderman JE, Dubois E, Friou G (1970) Deforming non-erosive arthritis of the hands in chronic systemic lupus erythematosus. Arthritis Rheum 13:329–339

    Google Scholar 

  6. Simmons-O’Brien E, Chen S, Watson R, Antoni C, Petri M, Hochberg M, Stevens MB, Provost TT (1995) One hundred anti-Ro (SS-A) antibody positive patients: a 10-year follow-up. Medicine (Baltimore) 74:109–130

    Article  CAS  Google Scholar 

  7. Richter-Cohen M, Steiner G, Smolen JS, Isenberg DA (1998) Erosive arthritis in systemic lupus erythematosus: analysis of a distinct clinical and serological subset. Br J Rheumatol 37:421–424

    Article  PubMed  CAS  Google Scholar 

  8. Arnett F, Edworthy S, Bloch D, McShane D, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–332

    Article  PubMed  CAS  Google Scholar 

  9. Kantor GL, Bickel YB, Barnett EV (1969) Coexistence of systemic lupus erythematosus and rheumatoid arthritis: report of a case and review of the literature, with clinical, pathological and serologic observations. Am J Med 47:433–444

    Article  PubMed  CAS  Google Scholar 

  10. Hahn BH, Yardley JH, Stevens MB (1970) Rheumatoid nodules in systemic lupus erythematosus. Ann Intern Med 72:49–58

    PubMed  CAS  Google Scholar 

  11. Schur PH (1971) Systemic lupus erythematosus. In: Beeson PB, McDermott W (eds) Cecil-Loeb textbook of medicine, 13 edn. WB Saunders, Philadelphia, p 821

    Google Scholar 

  12. Simón JA, Seeded J, Cabiedes J, Ruíz Morals J, Alcocer J (2002) Clinical and immunogenetic characterization of Mexican patients with ‘rhupus’. Lupus 11:287–292

    Article  PubMed  Google Scholar 

  13. Alarcon-Segovia D, Abud-Mendoza C, Diaz-Jouanen E, Iglesias A, de los Reyes V, Hernández-Ortiz J (1988) Deforming arthropathy of the hands in systemic lupus erythematosus. J Rheumatol 15:65–69

    PubMed  CAS  Google Scholar 

  14. Vugt RM, Derksen RH, Kater L, Bijlsma JW (1998) Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus. Ann Rheum Dis 57:540–544

    Article  PubMed  Google Scholar 

  15. Fischman AS, Abeles M, Zanetti M, Weinstein A, Rothfield NF (1981) The coexistence of rheumatoid arthritis and systemic lupus erythematosus: a case report and review of the literature. J Rheumatol 8:405–114

    PubMed  CAS  Google Scholar 

  16. Alarcón GS (2002) Syndromes indiferenciados y de sobeposición del tejido conectivo. Rev Mex Reumat 17:199–205

    Google Scholar 

  17. Cohen MG, Webb J (1987) Concurrence of rheumatoid arthritis and systemic lupus erythematosus: report of 11 cases. Ann Rheum Dis 46:853–858

    Article  PubMed  CAS  Google Scholar 

  18. Panush RS, Edwards L, Longley S, Webster E (1988) Rhupus syndrome. Arch Intern Med 148:1633–1636

    Article  PubMed  CAS  Google Scholar 

  19. Simón JA, Alcocer-Várela J (2001) Cual es la definición de Rhupus?. Rev Mex Reumat 16:111–119

    Google Scholar 

  20. Brand CA, Rowley MJ, Tait BD, Muirden KD, Whittingham SF (1992) Coexistent rheumatoid arthritis and systemic lupus erythematosus: clinical, serological, and phenotypic features. Ann Rheum Dis 51:173–176

    Article  PubMed  CAS  Google Scholar 

  21. Cervera R, Khamastha M, Font J, Sebastiani GD, Gil A, La-villa P, Domenech I, Aydintug AO, Jedryka-Goral A, de Ramon E et al (1993) Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore) 72:113–124

    CAS  Google Scholar 

  22. Blanco FJ, de la Mata J, Gómez Reigns JJ, Corrales A, Rodriguez Valverde V, Rosas JC, Pascual E (1995) Manifestaciones clÍnicas y serológicas de 307 pacientes españoles con lupus eritematoso sistèmico: Comparación con otros grupos étnicos. Rev Clin Esp 195:534–540

    PubMed  CAS  Google Scholar 

  23. Alarcon-Segovia D, Abud-Mendoza C, DÍaz-Jouanen E, Iglesias A, De Los Reyes V, Hernández-Ortiz J (1988) Deforming arthropathy of the hands in systemic lupus erythematosus. J Rheumatol 15:65–69

    PubMed  CAS  Google Scholar 

  24. Richter-Cohen M, Steiner G, Smolen JS, Isenber DA (1998) Erosive arthritis in systemic lupus erythematosus: analysis of a distinct clinical and serologic subset. Br J Rheumatol 37:421–424

    Article  PubMed  CAS  Google Scholar 

  25. Toone E, Irby R, Pierce EL (1960) The LE cell in rheumatoid arthritis. Am J Med Sci 240:599–608

    Article  PubMed  Google Scholar 

  26. Tishler M, Moutsopoulos HM, Yaron M (1992) Genetic studies of anti-Ro (SSA) antibodies in families with rheumatoid arthritis. J Rheumatol 19:234–236

    PubMed  CAS  Google Scholar 

  27. Mediwake R, Isenberg DA, Schellekens GA, van Venrooij WJ (2001) Use of anti-citrullinated peptide and anti-RA33 antibodies in distinguishing erosive arthritis in patients with systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis 60:67–68

    Article  PubMed  CAS  Google Scholar 

  28. Pistiner M, Wallace DJ, Nessim S, Metzger AL, Kleinenberg JR (1991) Lupus erythematosus in the 1980s: a survey of 570 patients. Semin Arthritis Rheum 21:55–64

    Article  PubMed  CAS  Google Scholar 

  29. Sontheimer RD, Provost TT (1997) Cutaneous manifestations of lupus erythematosus. In: Wallace DJ, Hahn BH (eds) Dubois’ lupus erythematosus, 5th edn. Williams & Wilkins, Baltimore, pp 569–623

    Google Scholar 

  30. O’Laughlin S, Schroeter AL, Jordon RE (1978) Chronic urticaria-like lesions in systemic lupus erythematosus. Arch Dermatol 114:879–883

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Rheumatology Unit, Universidad Nacional de Colombia, Bogota, Colombia

    Andrés Fernández, Gerardo Quintana, Federico Rondón, José Félix Restrepo, Alvaro Sánchez & Antonio Iglesias

  2. Division of Rheumatology, Mayo Clinic College of Medicine, 200 First Street, SW, 55905, Rochester, MN, USA

    Eric L. Matteson

Authors
  1. Andrés Fernández
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  2. Gerardo Quintana
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  3. Federico Rondón
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  4. José Félix Restrepo
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  5. Alvaro Sánchez
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  6. Antonio Iglesias
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  7. Eric L. Matteson
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Correspondence to Eric L. Matteson.

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Published online: 25 June 2005

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Fernández, A., Quintana, G., Rondón, F. et al. Lupus arthropathy: a case series of patients with rhupus. Clin Rheumatol 25, 164–167 (2006). https://doi.org/10.1007/s10067-005-1149-y

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  • DOI: https://doi.org/10.1007/s10067-005-1149-y

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