Introduction:
Rhupus syndrome is an uncommon but significant clinical condition, with
an estimated prevalence rate of just 0.09% 1.
Recognizing and understanding this disorder is crucial for effective
diagnosis and treatment. “Rhupus,” or “Rhupus syndrome,” is a rare
and overlooked condition that deserves greater attention. It is
characterized by symptoms associated with systemic lupus erythematosus
(SLE) and rheumatoid arthritis (RA) in the same
individual2. Despite its complexity, rhesus remains
poorly understood, highlighting the necessity for further research and
awareness in the medical community. It is a rare, neglected,
incompletely understood, and thus debated condition that is commonly
considered to feature the presence of symptoms of both SLE and
rheumatoid arthritis (RA) in the same patient.
Furthermore, psoriasis in the same patient creates a more challenging
issue. It may be due to the similarity in genetic pathways between SLE
& and Psoriasis, which may have made this
co-existence3. Evidence also presents that
paradoxically treating psoriatic patients with DMARD may result in new
autoimmune diseases4.
We recently encountered an intriguing case involving a 24-year-old man
who presented with a long-standing history of polyarthritis and distinct
hyperpigmented skin lesions. Initially diagnosed with psoriatic
arthropathy, further investigation unveiled a fascinating complexity of
autoimmune conditions, hinting at the potential of rhupus or
undifferentiated connective tissue disease (UCTD). Despite ongoing
treatment for psoriasis, the patient wasn’t responding as expected,
calling for deeper diagnostic exploration. After careful consideration
and consultations among expert clinicians, it became evident that we
were facing an overlap syndrome. While navigating the diagnostic maze
between undifferentiated connective tissue disease and rhupus, the team
came to a unanimous and hopeful conclusion: this is indeed rhupus. This
report highlights the intricate diagnostic journey, the therapeutic
strategies we explored, and the clinical challenges we faced while
managing this unique patient.