Abstract
Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.
Highlights
The concept of “rhupus” was proposed by Schur in 1971 [1]
Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria
We present the first series of rhupus in Niger
Summary
The concept of “rhupus” was proposed by Schur in 1971 [1] Observation 1: This is a 49-year-old patient suffering from chronic joint pain and swelling often debilitating on self-medication without improvement. She was admitted to the Internal Medicine Department of the General Reference Hospital in March 2021. The standard X-ray of the hands-facing revealed diffuse pinching of the joint space, geodes and left carpal radio-ulna erosions (Figure 1)
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