类风湿关节炎合并系统性红斑狼疮临床分析

Clinical Manifestations of Rheumatoid Arthritis and Concurrent Systemic Lupus Erythematosus

目的探讨类风湿关节炎(RA)与系统性红斑狼疮(SLE)重叠综合征(Rhupus综合征)临床特点。方法对1例Rhupus综合征患者的临床、实验室、影像学资料、治疗及预后进行回顾性分析,结合文献资料复习,探讨Rhupus综合征的临床特点。结果本例患者为中年女性,先出现RA表现,7年后出现SLE表现。本例患者肾脏损害重,有肾功能不全,糖皮质激素联合环磷酰胺治疗有效。结论Rhupus综合征在临床上罕见,患者往往先出现一种疾病的表现,数年至十余年后出现另一种疾病的表现,激素和免疫抑制剂治疗有效,及时诊断及正确治疗对于改善患者预后具有重要意义。

Objective To investigate the clinical manifestations of coexistent rheumatoid arthritis （RA） and systemic lupus erythe- matosus （SLE） （ Rhupus syndrome）. Methods Clinical data from a patient with Rhupus syndrome were analyzed combined with literature review. Results The patient was a middle - aged female, who presented with features of RA and developed features of SLE 7 years later. Renal involvement in common cases is rare but presented in our patient with severe renal dysfunction. The patient showed part remission with glucocorticosteroids and cyelopbosphamide therapy. Conclusion Rhupus syndrome is a rare condition sharing features of RA and SLE. These patients present with features of one disease but later on develop features of another. Glucocorticosteroids and immune suppressors are effective. Appreciation of these patients with rhupus is important since their therapy and outcome differ from those having RA or SLE alone.