RHUPUS: 5 CASES-BASED LITERATURE REVIEW
Mzabi A., Thabet M.*, Romdhane W., Anoun J., Ben Fredj F., Laouani C.
Introduction: Rhupus is a rare entity that combines systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The aim of this study is to describe the clinical and immunological profile of this disease. Materials and methods: Descriptive study of 5 patients with rhupus and follow-up by an internal medicine department over a period from 2005 to 2020. Diagnosis selected according to the ACR criteria of PR and SLIIC of LES. Result: These were 4 women and a man of an average age at diagnosis 51.8 years [43-58 years]. The mean duration of follow-up was 16.4 years. RA was initiator in three patients and two cases started with rhupus. Rhupus was associated with Gougerot Sjogren syndrome (n=3); anti-phospoholipid syndrome (n=2); primary biliary chirrosis (n=1) and leukocytoclastic vasculitis (n=1). Polyarthralgia was present in all of our patients; photosensitivity and malar rash in 2 patients. Two patients had Raynaud syndrm and arthritis. Hemolytic anemia with a positive CDT was noted in 2 patients. Hypergammaglobulinemia was noted in 3 patients. All of our patients had positive RF, anti CCP and ANA with titers ranged from 1/400 to 1/12,800. Three of our patients had positive anti native DNA. Two patients presented positif aCL and / or ACC and / or anti b2GPI. Anti-SSA were positif in 2 cases anti SSB (n =1) anti histone: (n =1) anti Sm (n=1) and anti RNP (n = 2). All of our patients were put on corticosteroid therapy and methotrexate and hydroxychloroquine was prescribed in 2 patients. Conclusion: Rhupus mainly concerns young women in the third decade. The clinical manifestations are essentially cutaneous articular.
Keywords: Rheumatoid arthritis, overlap, systemic Lupus Erythematosus.
[Full Text Article]