Особливості ювенільного Rhupus-синдрому з ураженням нирок: аналіз літератури та власний досвід

Abstract

Rhupus syndrome is a rare coexistence of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), characterized by symmetrical erosive polyarthritis and permanent deformities in addition to the clinical and serological features of SLE. Its prognosis is further complicated by neurological, and/or hematological, nephrological lesions, which sharply reduce the quality of life of patients. Clinical signs and consequences of Rhupus syndrome may differ in children and adults. Purpose - to acquaint doctors with the peculiarities of diagnosis, treatment, and observation of children with Rhupus syndrome, the importance of early diagnosis of complicated courses and disabilities. Clinical case. The authors present a clinical case of a 15-year-old girl with severe arthritis, which manifested simultaneously with clinical and serological signs of systemic lupus and developed secondary nephropathy at an early stage. JIA with the presence of specific autoantibodies to SLE in this case confirms the diagnosis of Rhupus. The child was treated with a disease-modifying antirheumatic drug (Methotrexate), steroids (Methylprednisolone), an angiotensin II receptor blocker, and other drugs in the treatment complex. Conclusions. Accurate diagnosis is the key to the correct diagnosis and choice of treatment strategy, as Rhupus syndrome is a very rare disorder with a very limited number of reported cases, but with the early realization of possible complications, such as kidney damage. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.