title: Rembrandt's Maria Bockenolle has a butterfly rash and digital deformities: overlapping syndrome of rheumatoid arthritis and systemic lupus erythematosus.
abstract: Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are the most common autoimmune disorders, although they each have very different pathophysiology. In general, RA is considered to be a Th1-mediated disease, while SLE is a Th2-mediated disease. Thus, their overlapping, in so called "rhupus", is a rare condition. In Rembrandt van Rijn's (1606-1669) portrait of the middle-aged Maria Bockenolle, we have what may be the earliest depiction of a case of rhupus syndrome: the coexistence of a butterfly rash and digital deformities. This suggests the possible historical importance of an RA epidemic which took place in the early 17th century.
authors.affiliation: Division of Infectious Disease Control and Clinical Immunology, Nihon University Medical Research Institute, 30-1 Ohyaguchi-kamimachi, Itabashiku, Tokyo 173-8610, Japan. satoshih@med.nihon-u.ac.jp <satoshih@med.nihon-u.ac.jp>
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hayakawa
authors.forename: Shihoko
authors.initials: S
authors.lastname: Komine-Aizawa
authors.forename: Shunzo
authors.initials: S
authors.lastname: Osaka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Iida
authors.forename: Junko
authors.initials: J
authors.lastname: Hayakawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Nishinarita
authors.forename: Norimichi
authors.initials: N
authors.lastname: Nemoto
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D005260:Female; D049670:History, 17th Century; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D008512:Medicine in the Arts; D009426:Netherlands; D010151:Paintings; D011173:Portraits as Topic / Q000266:history*; D013577:Syndrome