Learning More About Patients with "Rhupus": People with Lupus Whose Severe Arthritis Resembles Rheumatoid Arthritis (RA)
Arthritis Research & Therapy, Volume 8, Issue 5, August 25, 2006, R144
Presence of antibodies against cyclic citrullinated peptides in patients with "rhupus": a cross-sectional study
The first description of a patient showing symptoms of both lupus and rheumatoid arthritis (RA) appeared in 1969. The condition came to be called "rhupus" as a way to acknowledge the overlapping characteristics of these two separate autoimmune conditions.
A group of researchers in Mexico City reviewed their panels of patients with lupus and RA and were able to identify seven female patients who met the diagnosis for both diseases. They used some of the newer tests for RA and lupus to further detail the clinical profiles of these seven individuals, and compared them to those of control groups made up of people with RA, people with lupus, and people with no autoimmune disease.
In particular, the research team looked at the presence of antibodies against cyclic citrullinated peptides (anti-CCP), which are thought to be highly specific for RA and rarely present in lupus or other autoimmune diseases, and also for anti-dsDNA and anti-Sm antibodies, which are highly specific for lupus.
A majority of the rhupus patients in this study had anti-CCP antibodies, as did six of seven of the RA controls; on the other hand, none of the patients from the lupus or healthy control groups was positive for anti-CCP. In addition, a majority of the rhupus patients also had higher levels of the lupus-specific antibodies, which were not detected in the RA controls.
These results support the possibility that rhupus is an overlap between RA and lupus. This might have some interesting implications for how best to treat these patients, since some treatments may be optimal for both disorders, while others are not.