Rhupus: About Two Clinical Cases in Niger and Literature Review
- 1 Department of Internal Medicine and Geriatric, Reference General Hospital, Niamey, Niger
- 2 Department of Internal Medicine and Geriatric, Reference General Hospital, Niamey, Niger
- 3 Department of Internal Medicine, Hôpital National de Niamey, Niamey, Niger
- 4 Department of Internal Medicine and Geriatric, Reference General Hospital, Niamey, Niger
- 5 Department of Internal Medicine and Geriatric, Reference General Hospital, Niamey, Niger
- 6 Department of Internal Medicine, Hôpital National de Niamey, Niamey, Niger
Abstract
Background: Rhupus is the rare association of two autoimmune diseases, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) diagnosed according to validated ACR criteria. We present the first series of rhupus in Niger. Observation 1: This is a patient suffering from chronic polyarthritis in whom the diagnosis of active seropositive, erosive and deforming RA had been made according to the 1987 ACR criteria and SLE on the presence of 4 criteria according to the 1997 ARA criteria and putting under conventional synthetic DMARDs. The outcome was favorable with a remission achieved after 8 weeks with a disease activity score (DAS) 28 at 2.2. Observation 2: 58-year-old patient with known diabetes type 2 in whom the diagnosis of rhupus was made according to the ACR/EULAR 2010 criteria for RA with a DAS28 of 3.6 and the 2019 LES criteria at 18 points with a SLEDAI score of 6. The evolution was marked by the occurrence of a myocardial infarction with a favorable outcome under medical management. Conclusion: Rhupus is a rare entity that can be complicated by cardiovascular events with the presence of an independent cardiovascular risk factor.
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