Systemic Lupus Erythematosus (SLE)-Associated Jaccoud’s Arthropathy

TL;DR

A 27-year-old man with joint deformities and SLE markers was diagnosed with Jaccoud’s arthropathy and showed improvement with treatment.

Contribution

This case highlights the importance of recognizing Jaccoud’s arthropathy in SLE for accurate diagnosis and treatment.

Findings

The patient exhibited typical joint deformities and positive SLE markers without swelling or fever.

Treatment with prednisone, diclofenac, and hydroxychloroquine improved symptoms and antibody levels.

JA should be considered in SLE patients with deforming, non-erosive arthritis to avoid misdiagnosis.

Abstract

Jaccoud’s arthropathy (JA) is a chronic deforming arthropathy, initially linked to rheumatic fever, now more commonly associated with systemic lupus erythematosus (SLE). We report a case of a 27-year-old male presenting with a four-month history of joint pain in the bilateral hands and feet, accompanied by stiffness but no swelling, erythema, or fever. Physical examination revealed flexion deformities, ulnar deviation at the metacarpophalangeal joints, and hyperextension at the proximal interphalangeal joints, without tenderness. Laboratory findings showed elevated anti-double stranded DNA (anti-dsDNA) antibodies and positive antinuclear antibodies (ANA), and imaging confirmed non-erosive arthropathy. Diagnosed with SLE-associated JA, the patient was treated with prednisone, diclofenac, and hydroxychloroquine, leading to significant symptom improvement and decreased anti-dsDNA antibody levels. Even though non-erosive and non-deforming arthropathy is more commonly seen in SLE, timely identification of JA as a non-erosive but deforming arthritis is crucial in differentiating SLE from rheumatoid arthritis. This case underscores the need for comprehensive evaluation and tailored therapy in complex autoimmune conditions to prevent long-term joint damage and improve patient outcomes.

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