Background Jaccoud?s arthropathy (JA) is a deforming but non erosive arthropathy that can affect patients with systemic lupus erythematosus (SLE).
Objectives To characterise SLE-associated JA (SLE-JA), and to compare the clinical and laboratory manifestations of SLE patients, with or without JA.
Methods From our cohort of 860 SLE patients, we selected all patients with clinical JA, as well as 86 patients without JA. Patients with erosive arthropathy were excluded. Clinical and laboratory manifestations were compared between the two groups.
Results We found 20 patients with SLE-JA (19 females, 1 male, all caucasians). Their mean age at SLE onset was 29.3 ± 12.5 yrs; mean duration of arthritis was 20.1 ± 8.6 yrs; mean number of 1982 ARA criteria for SLE was 5.9 ± 1.5 (range 4–9). Main deformations were ulnar drift (75%), swan neck deformities (85%), Z deformity of the thumbs (80%) and boutonniere deformities (5%). JA of the feet was present in 4 patients, with hallux valgus (15%) or hammer toes (5%) deformities. Major hyperlaxity of other joints was noted in 2 patients (10%) and tendon rupture in 5 (25%). Five patients underwent hand surgery for correction of deformities. Compared to SLE cases without JA, patients with SLE-JA had a higher frequency of Raynaud’s phenomenon (50% vs 15%; p < 0.002) and IgM rheumatoid factor positivity (37% vs 15%; p < 0.04), and a lower frequency of lymphopenia (45% vs 71%; p < 0.03). No SLE-JA patient had antikeratin or antiperinuclear antibodies (ab). Anti-RA33 ab was absent in all 14 SLE-JA patients tested. The prevalence of other manifestations, including those related to antiphospholipid syndrome or SJÖGREN’S syndrome, was not different in the two groups.
Conclusion SLE-JA seems a rare condition. Rheumatoid factor inconstantly identifies this SLE subset, but the absence of other RA-associated ab, such as antifilaggrin ab, helps to differentiate SLE-JA from RA associated with SLE.
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