[2009] [THU0268] EROSIVE OR DEFORMING ARTHRITIS IN SYSTEMIC LUPUS ERITHEMATOSUS: JACCOUD'S ARTHRITIS, OVERLAP SYNDROMES OR MIXED CONNECTIVE TISSUE DISEASE?

E. Becerra, F. Lopez-Longo, E. Calvo, M. Carpena, I. Diez-Merchan, D. Gerona, C. Porras, C. Marin, F. Aramburu, C. Gonzalez, M. Montoro, I. Monteagudo, L. Carreño Rheumatology, Gregorio Marañon General University Hospital, Madrid, Spain

Background: The erosive or deforming arthritis described in patients with systemic lupus erythematosus (SLE) can be due to the inclusion of patients fulfilling also diagnostic criteria of mixed connective tissue disease (MCTD) or Overlap Syndromes in SLE series.
Objectives: To study the characteristics of arthritis in patients with SLE and its relation to Overlap Syndromes and MCTD.
Methods: We designed a case-control study. We reviewed the characteristics of arthritis in 430 patients diagnosed with SLE (1997 ACR) between the years 1987 and 2006. Ninety-three of these 430 patients met MCTD, polymyositis, rheumatoid arthritis (with X-ray compatible, nodules or erosions) or scleroderma criteria and were compared with patients who only met SLE criteria. In the latter group, patients with arthritis were compared with patients without arthritis.
Results: 320/430 SLE patients (74%) developed arthritis; in 116 patients (27%) the arthritis was persistent or chronic (> 6 weeks), 26 patients had rheumatoid nodules (6%), 23 subluxations (5.3%) and 17 joint erosions (4%). The 93 patients with SLE who met criteria for EMTC or Overlap Syndromes showed a significant increase (p <0.005) of chronic polyarthritis (OR 6.29), nodules (OR 8.15) and erosions (OR: 69.81). From the 337 patients who met exclusively criteria for SLE, 212 had arthritis (63%), which was persistent in 66 cases (31%). The most frequent patterns have been oligoartritis (47%) and polyarthritis (32%), acute or intermittent. In 66 of the 212 patients arthritis was persistent (31%), generally oligoarthritis or non-deforming, non erosive polyarthritis (51; 24%). Only 14/212 patients had erosive or deforming arthritis (6.6%), including 12 cases with Jaccoud's arthritis (5.6%), 2 deforming non-erosive polyarthritis and one erosive oligoarthritis. Arthritis was associated with fever (p <0.005), vasculitis and Raynaud's phenomenon (p <0.05), hypocomplementemia and increased anti-DNA levels (p <0.005).
Conclusion: In our experience, erosive or deforming arthritis is rare in SLE patients who do not meet criteria for MCTD or Overlap Syndromes. The so-called Jaccoud's arthritis is the most frequent deforming arthritis among them.
Disclosure of Interest: None declared

Ann Rheum Dis 2009;68(Suppl3):261

SLE, Sjögren's and APS Clinical aspects (other than treatment)