A comparative study on clinical and serological characteristics between patients with rhupus and those with systemic lupus erythematosus and rheumatoid arthritis
Por:
Frade-Sosa, B, Narvaez, J, Salman-Monte, TC, Castellanos-Moreira, R, Ortiz-Santamaria, V, Torrente-Segarra, V, Castellvi, I, Magallares, B, Reina, D, Minguez, S, Salles, M, de Lara, MGM, Ordonez, S, Riera, E, Schur, PH, Gomez-Puerta, JA, CAPICAT-MAS Study Grp
Publicada:
1 sep 2020
Ahead of Print:
1 jul 2020
Resumen:
Background The concomitant presence of two autoimmune diseases - systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) - in the same patient is known as rhupus. We evaluated a group of patients with rhupus to clarify further their clinical, serological and immunogenic features in a multi-centre cohort. In addition, the study aimed to explore the utility of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in our group of patients with rhupus. Methods This was a cross-sectional study. We included rhupus patients from 11 different rheumatology departments, and compared them to SLE and RA patients at a ratio of 2:1. All information was recorded following a pre-established protocol. Results A total of 200 patients were included: 40 rhupus patients and 80 each of SLE and RA patients as controls. Disease duration was similar among SLE and rhupus groups (around 13 years), but the RA group had a significantly lower disease duration. Main clinical manifestations were articular (94.2%), cutaneous (77.5%) and haematological (72.5%). Rhupus patients had articular manifestations similar to those expected in RA. Only 10% of rhupus patients had renal involvement compared with 25% of those with SLE (p < 0.05), while interstitial lung disease was more common in patients affected by RA. The 2019 EULAR/ACR SLE criteria were met in 92.5% of the rhupus patients and in 96.3% of the SLE cohort (p > 0.05). Excluding the joint domain, there were no differences between the numbers of patients who met the classification criteria. Conclusion Rhupus patients follow a particular clinical course, with full expression of both SLE and RA in terms of organ involvement, except for a lower prevalence of kidney affection. The new 2019 EULAR/ACR SLE criteria are not useful for differentiating SLE and rhupus patients. A new way of classifying autoimmune diseases is needed to identify overlapping clusters.
Filiaciones:
Frade-Sosa, B:
Hosp Clin Barcelona, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Narvaez, J:
Hosp Bellvitge Princeps Espanya, Rheumatol Dept, Barcelona, Spain
Salman-Monte, TC:
Hosp Mar, Rheumatol Dept, Parc Salut Mar IMIM, Barcelona, Spain
Castellanos-Moreira, R:
Hosp Clin Barcelona, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
Ortiz-Santamaria, V:
Hosp Gen Granollers, Rheumatol Dept, Granollers, Spain
Torrente-Segarra, V:
Hosp Comarcal Alt Penedes, Rheumatol Dept, Barcelona, Spain
Castellvi, I:
Hosp Santa Creu & Sant Pau, Rheumatol Dept, Barcelona, Spain
Magallares, B:
Hosp Santa Creu & Sant Pau, Rheumatol Dept, Barcelona, Spain
Reina, D:
Hosp St Joan Despi Moises Broggi, Rheumatol Dept, Barcelona, Spain
Minguez, S:
Xarxa Assistencial Univ Manresa, Rheumatol Dept, ALTHAIA, Manresa, Spain
Salles, M:
Xarxa Assistencial Univ Manresa, Rheumatol Dept, ALTHAIA, Manresa, Spain
de Lara, MGM:
Hosp Parc Tauli, Rheumatol Dept, Sabadell, Spain
Ordonez, S:
Hosp Arnau Vilanova, Rheumatol Dept, Lleida, Spain
Riera, E:
Hosp Mutua Terrassa, Rheumatol Dept, Barcelona, Spain
Schur, PH:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, 75 Francis St, Boston, MA 02115 USA
Gomez-Puerta, JA:
Hosp Clin Barcelona, Rheumatol Dept, Villarroel 170, Barcelona 08036, Spain
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