Photo Credit: bymuratdeniz
The following is a summary of “Dual seropositive nonerosive lupus arthritis: rhupus or not?” published in the February 2025 issue of Advances in Rheumatology by Pekdiker & Kara.
Researchers conducted a prospective study to investigate lupus arthritis (LA) in patients with clinical and serological similarities to rheumatoid arthritis (RA).
They reviewed electronic medical files of patients with systemic lupus erythematosus (SLE) from a tertiary rheumatology department (2017–2022). They included patients aged ≥18 years with nonerosive peripheral arthritis >6 months and dual seropositivity (rheumatoid factor (RF) and anti-citrullinated protein antibody (anti-CCP)). They confirmed a non-erosive course using radiography and ultrasound, assessed by 2 blinded rheumatologists. They excluded patients with drug-induced lupus or other rheumatologic diseases.
The results showed that out of 528 cases, 8 female patients (median age 48.5) met the criteria. The median SLE and arthritis durations were 12 and 7 years. Photosensitivity was present in all, and 1 had LTI (seizure and autoimmune hemolytic anemia). Arthritis affected the wrist and hand in all. Anti-dsDNA (n=7) and anti-SSA (n=5) were the most common antibodies. Median RF and anti-CCP titers were 82.5 IU/ml and 81.5 U/ml. About 5 had high autoantibody titers, 1 had slight hypocomplementemia, and 3 required biologics, achieving remission with rituximab.
Investigators found that despite long arthritis duration and dual seropositivity, patients had SLE rather than rhupus syndrome. They noted a low frequency of LTIs and highlighted the need for prospective studies to define LA better.
Source: advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-025-00440-z
