
Rhupus Syndrome Presenting as Interstitial Lung Disease: A Case Report
Correspondence Address :Srujan Sriram Yelamanchi,
Chettinad Hospital and Research Institute, SH 49A, Kelambakkam,
Chennai-603103, Tamil Nadu, India.
E-mail: srujanyalamanchi@gmail.com
Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA) are characterised by two distinct immunopathological activities, the T-helper 2 cells play a vital role in pathogenesis of SLE while T-helper 1 cells play an important role in RA. Organ involvement in Rhupus syndrome is relatively rare. Here, authors present a case of 59-year-old female who came with complaints of multiple joint pain (involving small and large joints) for a year and dyspnoea for 6 months without co-morbidities, on examination she had pallor, impaired percussion note and velcro crepitations in bilateral infrascapular region, her Pulmonary function test revealed a restrictive pattern and High-Resolution CT (HRCT) chest revealed sub-pleural reticulations involving lower lobes, she was diagnosed as RA with Interstitial Lung Disease (ILD) and started on hydroxycholoroquine, sulfasalazine and prednisolone. During follow-up after 6 months she developed a hyperpigmented rash over cheeks and bridge of nose, non-painful oral ulcers with Anti-Nuclear Antibodies (ANA) showing speckled positivity and Extractable Nuclear Antigen (ENA) panel showing positive anti-ds DNA and negative anti-histone, here with, we present a case of Rhupus syndrome presented with ILD. Recognising this condition is important as treatment varies between Rhupus syndrome and SLE or RA.
Cyclosporin, Rheumatoid arthritis, Systemic lupus erythematosus
DOI: 10.7860/JCDR/2021/46873.14558
Date of Submission: Sep 23, 2020
Date of Peer Review: Oct 16, 2020
Date of Acceptance: Jan 01, 2021
Date of Publishing: Feb 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 24, 2020
• Manual Googling: Jan 04, 2021
• iThenticate Software: Jan 15, 2021 (7%)
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