Overlapping juvenile idiopathic arthritis and systemic lupus erythematosus: a case report

Bazsó, Anna; Sevcic, Krisztina; Orbán, I; Poór, Gyula; Balogh, Zsolt J.; Kiss, Emese

doi:10.1007/s00296-010-1594-z

Cited by 8 publications

(8 citation statements)

References 22 publications

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“…Cutaneous manifestations are variable and may include maculopapular rash, malar rash, alopecia, photosensitivity, pruritus, and purpura . Although SLE may rarely arise concurrent with other autoimmune diseases, including JIA , the temporal association between symptom onset with anti‐TNF therapy initiation in our patient and gradual improvement after cessation of biologic therapy strongly suggests a drug‐induced process.…”

Section: Discussionmentioning

confidence: 72%

Adalimumab‐Induced Cutaneous Lupus Erythematosus in a 16‐Year‐Old Girl with Juvenile Idiopathic Arthritis

West

Nanda

Ofodile

et al. 2015

Pediatric Dermatology

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Tumor necrosis factor α (TNF-α) antagonists are used in the treatment of numerous autoimmune conditions. Adalimumab is the first monoclonal antibody to TNF-α and is used to treat juvenile idiopathic arthritis. A growing body of literature associates anti-TNF-α therapies with several adverse dermatologic manifestations, including drug-induced lupus erythematosus (LE). We describe a case of cutaneous LE in a 16-year-old girl treated with adalimumab for juvenile idiopathic arthritis. The temporal association between her presenting symptoms and adalimumab initiation and gradual improvement after stopping biologic therapy suggest adalimumab-induced cutaneous LE. With increasing use of anti-TNF therapies in children, the potential for drug-induced LE should not be overlooked.

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Section: Discussionmentioning

confidence: 72%

Adalimumab‐Induced Cutaneous Lupus Erythematosus in a 16‐Year‐Old Girl with Juvenile Idiopathic Arthritis

West

Nanda

Ofodile

et al. 2015

Pediatric Dermatology

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“…There are three viewpoints on RHUPUS. Some authors such as Fernandez believe that RHUPUS arthropathy is a serious articular involvement of lupus and it is different from a superposition or overlap of RA and SLE [16, 17], while other authors believe that RHUPUS syndrome is combination of SLE and chronic erosive polyarthritis [5, 9, 15], and the last group believes that RHUPUS is overlap of RA or JIA and SLE (regardless to poly or oligoarthritis and erosive or nonerosive) [4, 18]. We agree with last group about RHUPUS syndrome in children.…”

Section: Discussionmentioning

confidence: 99%

“…Since, RHUPUS is overlap of RA or RA and SLE, we suggested juvenile RHUPUS for overlap of JIA and JSLE. RHUPUS in children presents with features of JRA but later on develops features of SLE [4]. Although, few cases of RHUPUS syndrome present simultaneously with features of JRA and SLE as overlap syndrome, JRA and SLE as a presenting manifestation may not be complete [5].…”

Section: Discussionmentioning

confidence: 99%

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RHUPUS Syndrome in Children: A Case Series and Literature Review

Ziaee

Moradinejad

Bayat

2013

Case Reports in Rheumatology

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Objective. Overlap of juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) is a rare clinical condition in children. This condition has been described as RHUPUS syndrome. Prevalence of this syndrome and 3 cases are reported in this paper. Cases Presentation. During 10 years, 3 patients with SLE had chronic arthritis before or after diagnosis of SLE. Prevalence of this disorder in JSLE was 2.5%. Two patients were females and one of them was a male. According to our review, mean delay between chronic joint involvement and JSLE diagnosis was 50.1 months. In our case report, two females had joint erosion and one of them died due to heart failure, but in the literature review, just 45% cases had joint erosion and 70% cases were polyarticulare form. Conclusion. RHUPUS is unusual presentation of lupus in children. It seems that clinical feature and outcome of RHUPUS syndrome are different in children due to difference between RA and JIA. We suggest juvenile RHUPUS for overlap of JIA and JSLE.

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“…The comparison of last visit of patients On the other hand, chronic arthritis (CA) is an unusual condition in aSLE [4,8] and in cSLE [3,6]. Data in children has been limited mostly to case reports [3,[5][6][7] and to a large single center study comparing adults and children with CA focusing solely on distinct features in these two age brackets [8]. There are, however, no data regarding the possible clinical associations of CA in cSLE patients with and without this condition.…”

Section: Introductionmentioning

confidence: 99%

Characterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patients

et al. 2016

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Chronic arthritis (CA) is an unusual condition in childhood-onset systemic lupus erythematosus (cSLE) and data in children is very limited. The aim of the study is to assess CA in a large population of cSLE patients, in a multicenter cross-sectional study including 852 cSLE patients followed in ten Pediatric Rheumatology referral services in state of São Paulo, Brazil. CA was observed in 32/852 (3.7 %) cSLE patients mostly in hands and ankles. Chronic monoarthritis was diagnosed in four cSLE patients, oligoarthritis in nine and polyarthritis in 19. In the latter group, six had rhupus syndrome. Two oligoarticular patients had Jaccoud's arthropathy. CA was an isolated manifestation observed at disease onset in 13/32 (41 %) cSLE patients, and juvenile idiopathic arthritis (JIA) was the first diagnosis in 18/32 (56 %). The comparison of last visit of patients with CA and without this manifestation revealed higher frequency of splenomegaly (28 vs. 11 %, p = 0.002). The median of SLICC/ACR-DI score [1(0-9) vs. 0(0-7), p = 0.003] was significantly higher in CA patients compared to patients without this manifestation, likewise the frequency of musculoskeletal damage (31 vs. 9 % p = 0.001). Frequencies of treatment with nonsteroidal anti-inflammatory drugs (75 vs. 26 %, p < 0.0001), hydroxychloroquine sulfate (87 vs. 59 %, p = 0.001) and methotrexate (47 vs. 22 %, p = 0.001) were significantly higher in CA patients. This large multicenter study allowed us to characterize CA as a rare and early manifestation of cSLE, frequently mimicking JIA at disease onset. It is predominantly polyarticular, involving more often hands and ankles and it is associated with significant musculoskeletal accrual damage.

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Overlapping juvenile idiopathic arthritis and systemic lupus erythematosus: a case report

Cited by 8 publications

References 22 publications

Adalimumab‐Induced Cutaneous Lupus Erythematosus in a 16‐Year‐Old Girl with Juvenile Idiopathic Arthritis

Adalimumab‐Induced Cutaneous Lupus Erythematosus in a 16‐Year‐Old Girl with Juvenile Idiopathic Arthritis

RHUPUS Syndrome in Children: A Case Series and Literature Review

Characterization of chronic arthritis in a multicenter study of 852 childhood-onset systemic lupus erythematosus patients

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