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系统性红斑狼疮(SLE)相关的雅库病关节炎。

Systemic Lupus Erythematosus (SLE)-Associated Jaccoud's Arthropathy.

作者信息

Sanchez Rafael, Vala Lovekumar, Dhadhal Riya, Frontela Odalys, Aldrich Jose

机构信息

Department of Internal Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, USA.

Department of Internal Medicine, Shantabaa Medical College, Amreli, IND.

出版信息

Cureus. 2024 Aug 26;16(8):e67864. doi: 10.7759/cureus.67864. eCollection 2024 Aug.

DOI:10.7759/cureus.67864
PMID:39328671
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11424385/
Abstract

Jaccoud's arthropathy (JA) is a chronic deforming arthropathy, initially linked to rheumatic fever, now more commonly associated with systemic lupus erythematosus (SLE). We report a case of a 27-year-old male presenting with a four-month history of joint pain in the bilateral hands and feet, accompanied by stiffness but no swelling, erythema, or fever. Physical examination revealed flexion deformities, ulnar deviation at the metacarpophalangeal joints, and hyperextension at the proximal interphalangeal joints, without tenderness. Laboratory findings showed elevated anti-double stranded DNA (anti-dsDNA) antibodies and positive antinuclear antibodies (ANA), and imaging confirmed non-erosive arthropathy. Diagnosed with SLE-associated JA, the patient was treated with prednisone, diclofenac, and hydroxychloroquine, leading to significant symptom improvement and decreased anti-dsDNA antibody levels. Even though non-erosive and non-deforming arthropathy is more commonly seen in SLE, timely identification of JA as a non-erosive but deforming arthritis is crucial in differentiating SLE from rheumatoid arthritis. This case underscores the need for comprehensive evaluation and tailored therapy in complex autoimmune conditions to prevent long-term joint damage and improve patient outcomes.

摘要

雅库病(JA)是一种慢性变形性关节病,最初与风湿热有关,现在更常见于系统性红斑狼疮(SLE)。我们报告一例27岁男性病例,其双手和双脚关节疼痛4个月,伴有僵硬,但无肿胀、红斑或发热。体格检查发现有屈曲畸形、掌指关节尺侧偏斜和近端指间关节过伸,无压痛。实验室检查结果显示抗双链DNA(抗dsDNA)抗体升高,抗核抗体(ANA)阳性,影像学检查证实为非侵蚀性关节病。该患者被诊断为SLE相关的JA,接受了泼尼松、双氯芬酸和羟氯喹治疗,症状明显改善,抗dsDNA抗体水平下降。尽管非侵蚀性和非变形性关节病在SLE中更常见,但及时将JA识别为非侵蚀性但变形性关节炎对于区分SLE和类风湿关节炎至关重要。该病例强调了在复杂的自身免疫性疾病中进行全面评估和个体化治疗以防止长期关节损伤并改善患者预后的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc3/11424385/dbaa710b292d/cureus-0016-00000067864-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc3/11424385/dbaa710b292d/cureus-0016-00000067864-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dc3/11424385/dbaa710b292d/cureus-0016-00000067864-i01.jpg

相似文献

1
Systemic Lupus Erythematosus (SLE)-Associated Jaccoud's Arthropathy.系统性红斑狼疮(SLE)相关的雅库病关节炎。
Cureus. 2024 Aug 26;16(8):e67864. doi: 10.7759/cureus.67864. eCollection 2024 Aug.
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Jaccoud's arthropathy in systemic lupus erythematosus: differentiation of deforming and erosive patterns by magnetic resonance imaging.系统性红斑狼疮中的雅库病性关节病:通过磁共振成像区分变形和侵蚀模式
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本文引用的文献

1
Jaccoud's Arthropathy in a Case of Mixed Connective Tissue Disorder: An Interesting Tale.混合性结缔组织病合并Jaccoud关节病:一则有趣的病例
Cureus. 2022 Dec 31;14(12):e33170. doi: 10.7759/cureus.33170. eCollection 2022 Dec.
2
Arthritis in Systemic Lupus Erythematosus: From 2022 International GISEA/OEG Symposium.系统性红斑狼疮中的关节炎:源自2022年国际GISEA/OEG研讨会
J Clin Med. 2022 Oct 12;11(20):6016. doi: 10.3390/jcm11206016.
3
Imbalanced MMP-3 and MMP-12 serum levels in systemic lupus erythematosus patients with Jaccoud's arthropathy and a distinctive MRI pattern.
系统性红斑狼疮患者出现杰科关节病及特殊 MRI 表现时 MMP-3 和 MMP-12 血清水平失衡。
Rheumatology (Oxford). 2021 Sep 1;60(9):4218-4228. doi: 10.1093/rheumatology/keaa915.
4
Jaccoud-type lupus arthropathy: practical classification criteria.雅库病型狼疮性关节病:实用分类标准。
Lupus Sci Med. 2020 May;7(1). doi: 10.1136/lupus-2020-000405.
5
Severe Jaccoud's arthropathy in systemic lupus erythematosus.系统性红斑狼疮中的严重Jaccoud关节病。
Rheumatol Int. 2015 Oct;35(10):1773-7. doi: 10.1007/s00296-015-3351-9. Epub 2015 Aug 27.