Jaccoud´s arthropathy in systemic lupus erythematosus

Authors: Hrnčíř Zb;  M. Drahošová 1;  P. Bradna;  T. Soukup;  J. Tomš
Authors‘ workplace: II. interní klinika, oddělení revmatologie a klinické farmakologie, 1Ústav klinické imunologie a alergologie, Lékařská fakulta UK a Fakultní nemocnice, Hradec Králové
Published in: Čes. Revmatol., 18, 2010, No. 2, p. 68-72.
Category: Original Papers


Jaccoud´s arthropathy (JA) is a defined type of deforming involvement of small hand joints. JA is most commonly observed in systemic lupus erythematosus (SLE).

To explore frequency and clinical and laboratory characteristics of JA in SLE patients enrolled in a long-term follow-up program at one tertiary clinical centre.

Presence of JA was investigated in a consecutive cohort of 102 SLE (ACR/1982, updated in 1997) patients using scoring classification method according to van Vugt et al.: JA was considered present if the score exceeded 5/11 points. In SLE with JA, the following set of examinations was repeatedly evaluated: X-ray of hands, CBC, biochemistry, and immunological tests, especially Abs significant in relation to SLE and rheumatoid arthritis (RA). If lupus nephritis (LN) was suspected, a renal biopsy was performed, and LN classified according to INS/RPS 2003 criteria.

JA was found in 11/102 (10.78%) of SLE patients, incl. 8 patients with SLE only (7.84%), and 3 patients with SLE-RA overlap syndrome. Involvement of small hand joints was the first clinical manifestation in the medical history of 7/11 (63.63%) In the subgroup of SLE patients with JA: LN was found in 5/11 subjects (class II in 3, class III in 2). In patients with SLE-RA overlap syndrome, all patients were significantly positive for RF isotypes and ACPA tests.

JA in SLE is a relatively frequent syndrome with clinical significance. Involvement of small hand joints at the time of first clinical manifestation of SLE may mimic early RA; advanced deformities in JA may resemble established RA. Biopsy-proven LN in 45.0% SLE with JA is an interesting observation. Clinical, imaging, and immunological aspects of JA in SLE are under debate, and further studies are necessary.

Key words:
Jaccoud´s arthropathy, systemic lupus erythematosus, rheumatoid arthritis


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Dermatology & STDs Paediatric rheumatology Rheumatology
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