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

Overview

Background:
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).

Objective:
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.

Methods:
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.

Results:
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.

Conclusion:
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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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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