Introduction
Nearly 25% of systemic symptoms of autoimmune disorders are
misdiagnosed and mismanaged and often come with flare-ups or
complications. The coexistence of multiple rheumatic diseases makes it
more challenging regarding both management and diagnosis. Several types
of overlap syndrome are documented in the literature. While two or more
rheumatic diseases coexist, one disease often is clinically predominant.
Rhupus syndrome, which combines the clinical and laboratory aspects of
rheumatic arthritis (RA) and systemic lupus erythematosus (SLE), is one
of the uncommon and sporadically documented overlaps. SLE and RA are
systemic autoimmune rheumatic illnesses that affect multiple organs and
systems and have unique clinical and serological traits. (1)
“ Rhupus” was first coined in 1971 to describe patients who satisfy
the criteria for both systemic lupus erythematosus(SLE) and rheumatoid
arthritis(RA). (2) it has been defined as a deforming and symmetric
polyarthritis accompanied by symptoms of SLE and the presence of
antibodies such as ant-ds-DNA, anti-smith, and rheumatoid factor with or
without ant-CCP antibody. (a) because of the rarity of the disease the
prevalence, pathophysiology, natural history, and radiological and
immunological profiles profile of rhupus are poorly described.
There is no known etiology causing the disease but there are limited
studies suggesting the combined role of genetic, immunological,
hormonal, and environmental factors in the progression of the disease.
(3) identification of rhupus is very essential owing that their therapy
and outcome differ from those patients having RA or SLE alone. (4)
We report one such rare case below.
Case presentation :