Background Articular manifestation in systemic lupus erythematosus (SLE) is common and can range from arthralgia to chronic erosive deforming arthropathy.
Objectives This study was performed to determine the prevalence, clinical features, and serological findings in Thai SLE patients with deforming arthropathy.
Methods All SLE patients seen at the Rheumatology Clinic, Chiang Mai University Hospital, between January and December 2012, were included in this study. Their medical records were reviewed, together with a review of their history and physical examination, with special attention paid to the articular system. Those patients with evidence of hand arthropathy were invited to join the study. The arthropathy was classified according to van Vugt's classification.
Results Forty of 458 SLE patients (8.7%) had deforming arthropathy. Their mean ± SD age and disease duration were 34.5±14.7 years and 8.8±7.5 years, respectively. There were erosive arthritis with 13 (2.8%) cases, Jaccoud's arthropathy with 8 (1.7%), and mild deforming arthropathy with 19 (4.1%). Of these 40 patients, 23 (57.5%) were diagnosed rheumatoid arthritis (RA) with a mean duration of 7.5±8.9 years before the SLE diagnosis was made. Discoid rashes were significantly more common in the mild deforming arthropathy group (63.2%) than in the erosive arthritis group (7.7%) and the Jaccoud's arthropathy group (0.0%), p<0.01. Renal involvement was more common in the erosive arthritis group (69.2%) than in the Jaccoud's arthropathy group (62.5%) and mild deforming arthropathy group (47.4%), but without statistical significance. There was no statistical significant difference in the mean accumulative number of the ACR criteria, or the disease activity determined by sum of the MEX-SLEDAI score among the three groups. Patients in the erosive arthritis group had significantly more joint deformities than those in the non-erosive ones. Rheumatoid factor (RF) and anti-CCP were present in 38.5% and 30.8% of patients, respectively, in the erosive arthritis group, and 26.3% and 26.3% of patients, respectively, in the mild deforming arthropathy group. There was no presence of RF or anti-CCP in the Jaccoud's arthropathy group. Despite hand deformities, all group had maintained their hand functions, but with impaired grip and pinch strength.
Conclusions Deforming arthropathy is not uncommon in Thai patients with SLE, and shares similar clinical features to those previously reported.
Disclosure of Interest None declared