Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
Rheumatol Int. 2011 Jan;31(1):49-52. doi: 10.1007/s00296-009-1217-8. Epub 2009 Oct 23.
Jaccoud's arthropathy (JA) was initially described as a secondary complication to rheumatic fever (RF). However, most recently described cases are associated with systemic lupus erythematosus (SLE). At least in RF, this articular complication has been observed to occur in association with valvular heart disease. The aim of this work is to investigate the presence of valvulopathy in patients with SLE and JA, when compared to lupus patients without such complication. Patients with diagnosis of SLE based on the American College of Rheumatology criteria were enrolled in the study and divided into two groups: with or without JA and evaluated by transthoracic echocardiography. A total of 113 patients with SLE (25 with JA and 88 without JA) were assessed, of which 108 were females and five were males. Echocardiographic changes were found in 24 patients (21.2%) out of the entire population, including valvulopathy in 17 cases (15%), pulmonary hypertension in 7 cases (6.2%) and pericardial effusion in 2 cases (1.8%). In general, echocardiographic changes were more frequently seen in the JA group in comparison with the control group (p = 0.04). Additionally, in the JA group, valvulopathy was found in nine cases (36%) against eight cases (9%) in the control group (p = 0.001). This study reveals for the first time the association between the presence of valvular heart disease and JA in SLE patients, suggesting that the presence of JA may be a marker of such complication. Additional studies are required for clarification of the mechanisms involved in both complications.
雅可比关节炎（JA）最初被描述为风湿热（RF）的继发性并发症。然而，最近描述的大多数病例与系统性红斑狼疮（SLE）有关。至少在 RF 中，这种关节并发症与瓣膜性心脏病有关。本研究旨在探讨 SLE 患者伴 JA 与不伴此类并发症的狼疮患者之间瓣膜病的存在情况。根据美国风湿病学会标准诊断为 SLE 的患者被纳入研究，并分为两组：有 JA 和无 JA，并通过经胸超声心动图进行评估。共评估了 113 例 SLE 患者（25 例有 JA，88 例无 JA），其中 108 例为女性，5 例为男性。整个人群中有 24 例（21.2%）出现超声心动图改变，包括瓣膜病 17 例（15%）、肺动脉高压 7 例（6.2%）和心包积液 2 例（1.8%）。总的来说，与对照组相比，JA 组的超声心动图改变更为常见（p = 0.04）。此外，在 JA 组中，发现 9 例（36%）存在瓣膜病，而对照组中发现 8 例（9%）（p = 0.001）。本研究首次揭示了 SLE 患者中存在瓣膜性心脏病和 JA 之间的关联，提示 JA 的存在可能是此类并发症的标志物。需要进一步的研究来阐明这两种并发症涉及的机制。
