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Case Report: Rhupus (The Association of Systemic lupus Erythematosus and Rheumatoid Arthritis): About 2 Cases

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 84-88页

作者： Omar Boun Khatab Diouf Mouhamed Dieng Michel Assane Ndour Matar Ndiaye Nousradine Mourno Tarsa Boundia Djiba Ibrahima Mané Diallo Demba Diedhiou Anna Sarr Maimouna Ndour Mbaye Internal Medicine Departement Abass Ndao Hospital Dakar Senegal

Introduction: The association of systemic lupus erythematosus and rheumatoid arthritis (rhupus) is a rare clinical condition. Throughout the world, 287 cases of Rhupus have been described. We report two new observations of two patients who presented predominantly distal erosive polyarthritis with positive anti-Sm antibodies in one case and SmRNP in the other case. Observations: Case 1: 37 years old patient, with a recent diagnosis of pulmonary tuberculosis. She has since 8 months an inflammatory, bilaterally and symmetrical polyarthralgia without deformation or ankylosing synovitis, associated with malar erythema without other abnormalities. Immunological tests showed: positive Rheumatoid factor at 158 IU/ml, positive Anti-CCP at 550 IU/ml, and positivity of antinuclear at 1/1280 nuclear fluorescence with a strong presence of anti-Sm >8 IU/ml. The diagnosis of rhupus was concluded, without serious visceral involvement. Case 2: A 28-year-old patient, married with 3 children, with bilateral, symmetrical, deforming and chronic polyarthritis affecting large and small joints, which had been evolving for over 5 years without cutaneous abnormality associated. Paraclinical investigations showed: a biological inflammatory syndrome. Immunology was positive, with rheumatoid factors at 78 IU/ml, anti-CCP at 561 IU/ml, antinuclear antibodies at 1/1280 with positive anti-SmRNP and anti-SSA/Ro52, and a positive direct Coombs test. Joint ultrasound revealed tenosynovitis of the extensors and common flexors of the fingers, erosions and synovitis of multiple PPIs. The diagnosis of rhupus was based on the presence of 10 ACR criteria for RA and 8 ACR/EULAR 2019 criteria for SLE. Conclusion: Rheumatoid arthritis is a rare autoimmune disease combining features of both systemic lupus erythematosus and rheumatoid arthritis in the same patient, often sequentially. Despite a growing number of case reports and series, a consensus on the classification of SLE arthritis is still lacking, and diagnostic criteria for rhupus do not exist. These

关键词： Rhumatoïd Arthritis lupus Rhupus Connective Tissue Disease

Systemic lupus erythematosus

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四川生理科学杂志 2024年第4期46卷 863-863页

作者： Alberta Hoi Department of Rheumatology Monash Health School of Clinical Sciences Monash University Melbourne VIC Australia Department of Medicine Tuen Mun Hospital Hong Kong Special Administrative Region China Department of Rheumatology National Reference Center for Autoimmune Diseases INSERM UMR-S 1109 Hôpitaux Universitaires de Strasbourg Strasbourg France

Systemic lupus erythematosus(SLE)is a multisystemic autoimmune disease characterised by the presence of autoantibodies towards nuclear antigens,immune complex deposition,and chronic inflammation at classic target organs such as skin,joints,and kidneys.Despite substantial advances in the diagnosis and management of SLE,the burden of disease remains high.It is important to appreciate the typical presentations and the diagnostic process to facilitate early referral and diagnosis for patients.In most patients,constitutional,mucocutaneous,and musculoskeletal symptoms represent the earliest complaints;these symptoms can include fatigue,lupus-specific rash,mouth ulcers,alopecia,joint pain,and myalgia.In this Seminar we will discuss a diagnostic approach to symptoms in light of the latest classification criteria,which include a systematic evaluation of clinical manifestations(weighted within each domain)and autoantibody profiles(such as anti-double-stranded DNA,anti-Sm,hypocomplementaemia,or antiphospholipid antibodies).Nonpharmacotherapy management is tailored to the individual,with specific lifestyle interventions and patient education to improve quality of life and medication(such as hydroxychloroquine or immunosuppressant)adherence.

关键词： diagnosis lupus organs

Neuronal NR4A1 deficiency drives complement-coordinated synaptic stripping by microglia in a mouse model of lupus

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Signal Transduction and Targeted Therapy 2022年第3期7卷 840-855页

作者： Xiaojuan Han Tianshu Xu Congzhu Ding Dandan Wang Genhong Yao Hongwei Chen Qijun Fang Gang Hu Lingyun Sun Department of Rheumatology and Immunology Department of Traditional Chinese MedicineNanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western MedicineNanjing University of Chinese MedicineNanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina Department of Traditional Chinese Medicine Nanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina Department of Rheumatology and Immunology Nanjing Drum Tower Hospitalthe Affiliated Hospital of Nanjing University Medical SchoolNanjingChina Department of Pharmacology Nanjing University of Chinese MedicineNanjingJiangsuChina

Neuropsychiatric lupus(NPSLE)is a frequent manifestation of systemic lupus erythematosus(SLE)that occurs in 40-90%of SLE patients;however,the underlying mechanisms remain elusive,causing a severe lack of therapeutic targets for this condition.Here,we show that complement-coordinated elimination of synapses participated in NPSLE in MRL/lpr mice,a lupus-prone murine model.We demonstrated that lupus mice developed increased anxiety-like behaviors and persistent phagocytic microglial reactivation before overt peripheral lupus pathology.

关键词： lupus coordinated pathology

Systemic lupus erythematosus with diffuse alveolar hemorrhage

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Chinese Medical Journal 2023年第23期136卷 2883-2885页

作者： Rongxiu Huo Xinxiang Huang Jinying Lin Department of Rheumatology and Immunology Guangxi Academy of Medical SciencesThe People’s Hospital of Guangxi Zhuang Autonomous RegionNanningGuangxi 530016China

To the Editor:Systemic lupus erythematosus(SLE)is an autoimmune disease characterized by the production of various autoantibodies.Disease prevalence is 20 to 70 per 100,000 among adults,and 1.89 to 25.7 per 100,000 among children.[1,2]The pathogenesis of SLE is associated with immune disorders,especially involving the activation of B and T cells,which can lead to abnormal antibodies with nuclear and cytosolic antigens from apoptotic cells of the immune complexes(ICs)removing the damaged cells,and excessive activation of the complement system,thus causing damage to target organs,such as the kidneys and lungs.

关键词： erythematosus lupus organs damage

Identification of methylated differentially expressed hub genes in systemic lupus erythematosus patients by WGCNA-based epigenome-wide and transcriptome-wide analysis

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Genes & Diseases 2023年第5期10卷 1771-1774页

作者： Qiao Zhou Li Long Xixi Chen Xiaobo Huang Shaoping Deng Yi Wang Department of Rheumatology and Immunology Sichuan Academy of Medical Science and Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuan 610072China Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuan 610072China Department of Critical Care Medicine Sichuan Academy of Medical Science and Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of ChinaChengduSichuan 610072China

Systemic lupus erythematosus(SLE)is an autoimmune disease,characterized by the production of autoantibodies and the involvement of multi-systems.In order to explore its molecular mechanism,we,using bioinformatics anal... 详细信息

关键词： lupus erythematosus SLE

Clinical efficacy of tacrolimus in systemic lupus erythematosus with various manifestations:a real-world study

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Chinese Medical Journal 2022年第18期135卷 2245-2247页

作者： Wei Bai Mengtao Li Shuang Zhou Liying Peng Jiuliang Zhao Xinping Tian Qian Wang Xiaomei Leng Shangzhu Zhang Yanhong Wang Yan Zhao Xiaofeng Zeng Department of Rheumatology and Clinical Immunology Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID)Ministry of Science and TechnologyState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College Hospital(PUMCH)Key Laboratory of Rheumatology and Clinical ImmunologyMinistry of EducationBeijing 100730China Department of Epidemiology and Bio-statistics(YW) Institute of Basic Medical ScienceChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100053China

To the Editor:Systemic lupus erythematosus(SLE)is an autoimmune disease involving multiple systems.In recent years,the therapeutic treat-to-target(T2T)strategy was recommended for SLE.^([1])The immunosuppressive drugs are the standard of care in SLE treatment.Tacrolimus was one of the calcineurin inhibitors which was recommended in the 2019 update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association recommendations for the management of lupus nephritis(LN)^([2]).

关键词： lupus erythematosus drugs

Repression of interferon regulatory factor-4(IRF4)hyperactivation restricts murine lupus

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Signal Transduction and Targeted Therapy 2023年第6期8卷 2475-2477页

作者： Shijun He Huihua Ding Li Chen Yiwei Shen Yuting Liu Fenghua Zhu Xiaoqian Yang Nan Shen Zemin Lin Jianping Zuo Innovation Research Institute of Traditional Chinese Medicine Shanghai University of Traditional Chinese MedicineShanghaiChina Laboratory of Immunopharmacology State Key Laboratory of Drug ResearchShanghai Institute of Materia MedicaChinese Academy of SciencesShanghaiChina Department of Rheumatology Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Dear Editor,Hyperactivation of the type I interferon(IFN)signature has been observed in several systemic autoimmune conditions,and the type I IFN receptor antagonist Saphnelo(anifrolumab-fnia)has been approved in 2021 by the Food and Drug Administration(FDA)in the US.The launch of Saphnelo marked the only new treatment approved for systemic lupus erythematosus(SLE)in more than 10 years.

关键词： lupus interferon activation

Ferroptosis as an important driver of lupus

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Protein & Cell 2022年第5期13卷 313-315页

作者： Chao Mao Guang Lei Li Zhuang Boyi Gan Department of Experimental Radiation Oncology The University of Texas MD Anderson Cancer CenterHoustonTXUSA The University of Texas MD Anderson UTHealth Graduate School of Biomedical Sciences HoustonTXUSA

Systemic lupus erythematosus(SLE),the most common form of lupus,is a chronic autoimmune disorder characterized by a global loss of self-tolerance and hyper-activation of both innate and adaptive immune systems(Kaul et al.,2016).Neutrophils,the most abundant leukocytes in human blood,have a critical role in maintaining immune surveillance and tissue homeostasis,and its dysregulation is of high relevance to SLE(Ricklin et al.,2010).In patients with SLE,accelerated neutrophil death and the deficiency in clearing dying neutrophils cause nuclear and cytoplasmic antigen exposure,excessive production of type I interferon(IFN),and neutrophil extracellular trap(NET)release,subsequently inducing autoimmune responses(Garcia-Romo et al.,2011).Dysregulated neutrophil death is believed to be a major cause of SLE;however,the underlying mechanism of neutrophil death in SLE is not well-defined.

关键词： al. lupus autoimmune

Systemic lupus erythematosus in a male teenager manifested with cardiogenic shock and extremities infarction

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World Journal of Emergency Medicine 2022年第5期13卷 406-408页

作者： Li-xue Wu De-chao Xu Ke Sun Hao Huang Wei-wei Jiang Wen-fang Li Department of Emergency and Critical Care Medicine Changzheng HospitalNaval Medical UniversityShanghai 200003China Department of Nephrology Changzheng HospitalNaval Medical UniversityShanghai 200003China

Systemic lupus erythematosus(SLE)is an autoimmune disease with multisystemic features and a variety of clinical characteristics.Typical clinical manifestations of SLE include alopecia,oral ulcers,cutaneous lesions,arthritis,renal injury,and cardiac damage.[1]Cardiac involvement is one of the common complications of SLE,which is mostly asymptomatic with only approximately 10%of cardiac injury patients experiencing symptoms such as shortness of breath and arrhythmia.However,cardiogenic shock is rare,especially as the initial manifestation of SLE.[2]Herein,we report a case of a 15-year-old male who presented with cardiogenic shock and was eventually diagnosed with SLE.

关键词： erythematosus lupus involvement