Abstract
We describe the case of a 55-year-old women with an erosive, destructive and seropositive rheumatoid arthritis (RA), who developed after 24 years the clinical and serological signs of an systemic lupus erythematosus (SLE). The diagnosis of a SLE could be made by the clinical findings after the criteria of the American College of Rheumatology (7 criteria were present) and was confirmed by a biopsy of the kidneys, by which we found an acute membranoproliferative lupus glomerulonephritis. The patient also fulfilled all 7 of the ARA-criteria from 1987 for an RA. Therefore we diagnosed a true overlap syndrome of RA and SLE.
After the case report we present a review of the literature over the last 15 years. The rarity of the concurrence of an RA and SLE in the same patient is shown and the importance of a good clinical and serological examination of patients suffering from an RA is emphasized. These periodical examinations are necessary to detect a transition of an RA into a SLE or an other connective tissue disease.
Zusammenfassung
Wir beschreiben den Fall einer Patientin, die über Jahre an einer progredienten seropositiven chronischen Polyarthritis litt und nach 24 Jahren zusätzlich die klinischen und serologischen Befunde eines systemischen Lupus erythematodes mit mittelschwerer Nierenbeteiligung entwickelte. Sie erfüllte sowohl die Kriterien des American College of Rheumatology (ACR) für eine chronische Polyarthritis, als auch diejenigen für einen systemischen Lupus erythematodes. Die klinischen Befunde und die Laborresultate werden beschrieben und das seltene Krankheitsbild eines Overlapsyndroms von chronischer Polyarthritis und systemischem Lupus erythematodes anhand der Literatur dargestellt.
