title: Clinical analysis of 56 patients with rhupus syndrome: manifestations and comparisons with systemic lupus erythematosus: a retrospective case-control study.
abstract: To investigate the clinical features of Rhupus syndrome, we retrospectively reviewed the medical records of 56 patients with Rhupus who were hospitalized at the Peking Union Medical College Hospital, Beijing, China, between January 2000 and March 2013. We analyzed the clinical manifestations of Rhupus syndrome and compared these with a control group of 160 randomly selected systemic lupus erythematosus (SLE) patients without coexisting rheumatoid arthritis (RA). In our center, 1.30% (56/4301) of hospitalized SLE patients had Rhupus syndrome. The median disease duration was 8.0 years and 83.9% had RA onset. All Rhupus patients showed radiological erosion in the joints. Compared with the control group, Rhupus patients had a longer disease duration, higher prevalence of anticyclic citrullinated peptide antibody and rheumatoid factor, higher incidence of symmetrical polyarthritis with more joint deformities and rheumatic nodules, and increased erythrocyte sediment rate and c-reactive protein levels (P < 0.005). In addition, a lower SLE disease activity index and incidences of malar rash, hemolytic anemia, renal and neurological involvement (P < 0.005), and hypocomplementemia (P < 0.05) was observed in the Rhupus group.Rhupus syndrome is rare in SLE patients. Most Rhupus patients had RA onset and a distinctive clinical profile characterized by more severe RA-associated and mild SLE-associated damage. Specific autoantibodies and imaging findings could be helpful for making accurate Rhupus diagnoses.
authors.affiliation: Department of Rheumatology and Clinical Immunology (JL, DX, WZ, YZ, XZ), Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing; Department of Rheumatology and Clinical Immunology (HW), Central Hospital of Jinhua, Zhejiang; Department of Rheumatology and Hematology (XH), The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning; MOE Key Laboratory of Protein Science (WL), School of Life Sciences, Tsinghua University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Honghua
authors.initials: H
authors.lastname: Wu
authors.forename: Xinxiang
authors.initials: X
authors.lastname: Huang
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Wanli
authors.initials: W
authors.lastname: Liu
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids