#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Jaccoud´s arthropathy in systemic lupus erythematosus


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

Summary

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


Zdroje

1. Bywaters EGL. The relation between heart and joint disease including „rheumatoid heart disease“ and chronic post-rheumatic arthritis (type Jaccoud). Brit Heart J 1950; 12: 101-131.

2. Navrátil J, Štorková A. Jaccoudova artropatie – souborný referát. Čes Revmatol 1995; 3: 153-156.

3. Ehrenstein MR, Isenberg DA. Systemic lupus erythematosus in adults – clinical features and etiopathogenesis. In Isenberg DA, et al. Oxford Textbook of Rheumatology. 3. vyd. Oxford University Press, 2004: 819-842.

4. Wallace DJ. The musculosceletal system. In Wallace DJ, Hahn BH. Dubois‘ Lupus Erythematosus. 6. vyd. Lippinccott Williams Wilkins, Philadelphia, 2002: 629-644.

5. van Vugt RM, Derksen RHW, Kater L, et al. Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus. Ann Rheum Dis 1998; 57: 540-544.

6. Autorský kolektiv. Laboratorní vyšetření v klinické imunologii a alergologii. Hradec Králové: Garamon, vyd. 1, 2004: 1-112.

7. Weening JJ, D´Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney International 2004; 65: 521-530.

8. Spronk PE, ter Borg EJ, Kallenberg CGM. Patients with systemic lupus erythematosus and Jaccoud‘s arthropathy: a clinical subset with an increased C reactive protein response? Ann Rheum Dis 1992; 51: 358-361.

9. Olech E, Yocum DE, Hutcheson J, et al. Magnetic resonance imaging characteristics of structural changes in hands and wrists of patients with systemic lupus erythematosus. Arthritis Rheum 2006; 54: S621-622 (abstrakt).

10. Ostendorf B, Wirrwar A, Mattes-György K, et al. High-resolution SPECT imaging of bony pathology in early arthritis of finger joints. Rheumatology 2009; 48: 853-854.

11. Saketkoo LA, Quinet R. Revisiting Jaccoud arthropathy as an ultrasound diagnosed erosive arthropathy in systemic lupus erythematosus. J Clin Rheumatol 2007; 13: 322-327.

12. Hoffman IEA, Peene I, Cebecauer I, et al. Presence of rheumatoid factor and antibodies to citrullinated peptides in systemic lupus erythematosus. Ann Rheum Dis 2005; 64: 330-332.

13. Paredes JG, Lazaro MA, Citera G, et al. Jaccoud´s arthropathy of the hands in overlap syndrome. Clin Rheumatol 1997; 16: 65-69.

14. Williams EL, Gadola S, Edwards ChJ. Anti-TNF-induced lupus. Rheumatology 2009; 48: 716-720.

15. Santiago MB, Galvao V. Jaccoud arthropathy in systemic lupus erythematosus. Medicine 2008; 87: 37-44.

Štítky
Dermatology & STDs Paediatric rheumatology Rheumatology
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#