Rhupus syndrome: Assessment of its prevalence and its clinical and instrumental characteristics in a prospective cohort of 103 SLE patients

Rhupus; unusual presentations

“…The mean interval between the appearances of the two diseases was also different and varied from 4.6 to 16.5 years in patients with SLE as the first disease [11,13] and from 4.3 to 11 years in patients with RA as the first disease [9,11]. Taken together, this data confirms that this syndrome tends to develop sequentially and has a slowly progressive disease course [3,12].…”

“…Similarly to previous reports, the manifestation of RA in our Rhupus patients included severe deforming erosive polyarthritis [2,9,11,12], and the severity of the joint disease was confirmed by X-ray or MRI. Joint involvement, mostly of the wrists and hands, is also common in SLE patients and ranges from mild arthralgia that occurs frequently at the onset of the disease to late reducible deformities known as BJaccoud's arthropathy^ [14,15].…”

“…There are controversial data in literature regarding the onset of this disease, and the majority of reports state that RA manifested before SLE in most of the patients [2, 6-9, 11]. However, one recent report suggests that SLE preceded the onset of RA in 50 % of patients, 30 % of the patients developed both diseases at the same time, and in the rest of the patients, RA manifested before SLE [12]. The mean interval between the appearances of the two diseases was also different and varied from 4.6 to 16.5 years in patients with SLE as the first disease [11,13] and from 4.3 to 11 years in patients with RA as the first disease [9,11].…”

“…However, according to the ACR criteria set for SLE, only non-erosive arthritis is defined as SLE arthropathy [11,16]. This fact reinforces the importance of joints assessment by imaging techniques including X-ray, MRI, and musculoskeletal ultrasound (US) [12,17,18]. These techniques allow better classification and differentiation of SLE arthropathy from Rhupus syndrome, especially when physical examination is not conclusive or when the patient suffers from a severe persistent joint disease.…”

“…These techniques allow better classification and differentiation of SLE arthropathy from Rhupus syndrome, especially when physical examination is not conclusive or when the patient suffers from a severe persistent joint disease. It has been recently reported that US and MRI assist the early detection of bone erosions and more SLE patients may be diagnosed with Rhupus syndrome using these techniques [12].…”