rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2005-616rsp-754Research ArticleСтатьиArticlesДеформирующая артропатия кистей (синдром Жакку) при системной красной волчанкеHand deforming arthropathy (Jaccoud’s syndrome) in systemic lupus erythematosusZhornyakA. P.ZhornyakA. P.-IvanovaM MIvanovaM M-200515082005434№4 (2005)4246Copyright © Zhornyak A.P., Ivanova M.M., 20052005Zhornyak A.P., Ivanova M.M.Zhornyak A.P., Ivanova M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/754

Цель. Охарактеризовать деформирующую артропатию (ДА) кистей (синдром Жакку) при системной красной волчанке (СКВ). Материал и методы. Анализ историй болезни 235 больных СКВ, постоянно наблюдавшихся в ГУ Институте ревматологии РАМН с 1982 по 2002 гг., отбор из их числа и обследование 26 больных с ДА кистей (синдромом Жакку), соответствующих критериям D.AIarcon-Segovia (1988 г). Активность СКВ определялась по В.А.Насоновой и шкале SLEDAI-I. Результаты. Среди 235 больных СКВ ДА кистей (синдром Жакку) была выявлена у 26 пациенток (11%). Более чем у четверти из них это повреждение сформировалось на 1-м году заболевания и характеризовалось неэрозивным поражением суставов с образованием деформаций пальцев по типу "шеи лебедя", "бутоньерки", появлением Z-образной деформации большого пальца, амиотрофии и ульнарной девиации кистей. Установлено, что более длительная ГК терапия отдаляла сроки развития ДА кистей(г=0,64, р=0,0003) .

Objective. To characterize Jaccoud’s syndrome - hand deforming arthropathy (HDA) in systemic lupus erythematosus (SLE). Material and vethods. Analysis of 235 case histories of pts with SLE followed up in the Institute of Rheumatology of RAMS from 1982 to 2002 was performed. 26 from them had HDA according to D. Alarcon-Segovia criteria (1988). SLE activity was determined according to V.A Nassonova and SLEDAI-I scale. Results. 26 from 235 SLE pts (11 %) had H DA. More than in 25% from them this damage formed during the first year of the disease and included nonerosive joint damage with the development of finger deformities such as "swan neck", "boutonniere", Z-deformity of thumb, muscle atrophia and ulnar deviation. Longer treatment with glucocorticoids put off HDA development (r=0,64, p=0,0003)

системная красная волчанкадеформирующая артропатия кистей"Jaccoud's arthropathy index"systemic lupus erythematosushand deforming arthropathy"Jaccoud's arthropathy index"References<div><p>Иванова М.М. Системная красная волчанка. Клиника, диагностика и лечение. Кпинич. ревматол., 1995,1, 2-17.</p><p>Иванова М.М., Гусева Н.Г., Несговорова Л.И. Хронический полиартрит при диффузных болезнях соединительной ткани. В кн.: Ревматоидный артрит. Под ред. Насоновой В.А., М.,''Медицина", 1983,105-108.</p><p>Иванова М.М., Несговорова Л.И., Мылов Н.М., Насонова В.А. Lupus arthritis. Scand. J. Rheumatol. 1984, 52, 82-85.</p><p>Насонова В.А. Системная красная волчанка. М., «Медицина», 1972,41-49.</p><p>Несговорова Л. И. Суставной синдром в клинике системной красной волчанки (клинико-рентгено-морфологическое исследование). Дисс.к.м.н. М., 1964.</p><p>Шостак Н.А. Об артропатии Жакку. Тер.архив, 1995, 11, 8083.</p><p>Agnello V., ArbetterA., Ibanezde Kasep G. et al. Evidence fora subset of rheumatoid factors that cross react with DNA-histone and have a distinct cross-idiotype. J. Exp. Med., 1980, 151,15141527.</p><p>Alarcon-Segovia D., Abud-Mendoza C., Diaz-Jouanen E. et al. Deforming arthropathy of the hands in systemic lupus erythematosus. J.Rheumatol., 1988, 15, 1,65-69.</p><p>Babini S.M., Cocco М., de la Sota M. et al. Tendinous laxity and Jaccoud's syndrome in patients with SLE. Possible role of secondary hyperparsthyroidism. J. Rheumatol., 1989, 16, 4, 494498.</p><p>Bleifield C.J, Inglis A.E. The hand in systemic lupus erythematosus. J. Bone Joint Surg., 1974, 56A, 1207-1215.</p><p>Bywaters E.G.L. Jaccoud's syndrome: Today's view. Clin. Rheumatol. Pract., 1986, 4,153-155.</p><p>Bywaters E.G.L. The relation between heart and joint disease (type Jaccoyd's). Br.Heart J., 1950, 12, 101-131.</p><p>Cohen M.R., Steiner G., Smolen J.S., Isenberg DA. Erosive arthritis in systemic lupus erythematosus: analysis of a distinct clinical and serological subset. Br. J. Rheumatol., 1998, 37, 421424.</p><p>Cohen M.G., Wfebb J. Concurrence of rheumatoid arthritis and systemic lupus erythematosus: report of 11 cases. Ann.Rheum.Dis., 1976, 46, 853-858.</p><p>Cronin M.E. Musculoskeletal manifestations of systemic lupus erythematosus. Rheum. Dis. Clin. North Am., 1988, 14(1), 99116.</p><p>Cruickshank B. Lesions of joints and tendon sheaths in systemic lupus erythematosus. Ann. Rheum. Dis., 1959, 18,111-119.</p><p>Dray GJ. The hand in systemic lupus erythematosus. Hand Clin., 1989, 5, 145-155.</p><p>Esdaile J.M., DanofT D., Rosenthall L., Gutkowski A. Deforming arthritis in systemic lupus erythematosus. Ann.Rheum.Dis. 1981,40(2), 124-126.</p><p>Evans J.A., Hastings D.E., Urowits M.B. The fixed lupus hand deformity and its surgical correction. J.Rheumat., 1977, 4(2), 170-175.</p><p>Gould D.M., Daves M.L. Roentgenologic findings in SLE. An analysis of 100 cases. J.Chronic Dis., 1955,2, 136-145</p><p>Hannestad К., Rekving D.P., Husebekk A. Cross reacting rheumatoid factors and lupus erythematosus (LE) factors. Springer Semin. Immunopathol., 1981,4,133-160.</p><p>Isenberg D.A., Horsfall A. Systemic lupus erythematosus - adult onset. In: Maddison P.J. at al. Oxford textbook of rheumatology. 2nd edn. Oxford: Oxford University Press, 1998, 11451180.</p><p>Jaccoud F.S. Sur une forme de rhumatisme chronique: lecons de clinique Medicale faites a l'Hopital de la Charite. Paris: Dclahaye, 1869,598-616.</p><p>Kramer L.S., Ruderman J.E., Dubois E.L., Friou G.T. Deforming non-erosive arthritis of the hands in chronic SLE. Arthr. Rheum., 1970, 13. 329-330.</p><p>Labowitz R., Schumacher H.R.Jr. Articular manifestation of systemic lupus erythematosus. Ann.Intern.Med., 1971,74, 911 -921.</p><p>Lawless O.J., Whelton J.C. Deforming hand arthritis in systemic lupus erythematosus. [Abstr.|. Arthr.Rheum., 1974, 17, 323.</p><p>Ostendorf B., Scherer A., Specker Ch. et al. Jaccoud's arthropathy in systemic lupus erythematosus. Differentiation of deforming and erosive patterns by MRI. Arthr.Rheum., 2003, 1, 157165.</p><p>Palazzo E., Bourgeois P., Meyer O. et al. Hypo-complc- mentemic urticarial vasculitis syndrome, Jaccoud?s syndrome, valvulopathy: A new syndromic combination. J.Rheumatol., 1993, 20,1236-1240.</p><p>Reilly P.A., Evison G., McHugh N.J., Maddison P.J. Arthropathy of hands and feet in systemic lupus erythematosus. J.Rheumatol., 1990, 17, 777-784.</p><p>Russel F.S., Percy J.S., Rigal W.W., Wilson G.L. Deforming arthropathy in systemic lupus erythematosus. Ann. Rheum. Dis., 1974,33,204. ’</p><p>Spronk P.E., Ter Borg E.J., Kallenberg C.G.M. Jaccoud's arthropathy: a clinical subset with an increased C-reactive protein response. Ann.Rheum.Dis., 1992, 51,358-361.</p><p>Sturgess A.S., Littlejohn G.O. Jaccoud's arthritis and panvasculitis in the hypocomplementemic urticarial vasculitis syndrome. J.Rheumatol. 1988, 15, 858-861.</p><p>Van Vugt R.M., Derksen R.H., Kater L., Bijlsma J.W. Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus. Ann. Rheum. Dis., 1998, 9, 540-544.</p><p>fclayos E.E., Leidholt J.D., Smyth C.J. et al. Arthropathy associated with steroid therapy. Ann. Intern. Med., 1966, 64, 759771.</p><p>Wallace D.J., Hahn B.H., Quismorio F.P., Klinenberg J.R. Duboi's lupus erythematosus. 5-th ed. Philadelphia: Lea and Fibeger, 1977,635-639.</p><p>Wfeissman B.N., Rappoport A.S., Sosman J.L., Schur P.H. Radiographic findings in the hands in patients with systemic lupus erythematosus. Radiology, 1978, 126, 313-317.</p></div><br /><div><p>Иванова М.М. Системная красная волчанка. Клиника, диагностика и лечение. Кпинич. ревматол., 1995,1, 2-17.</p><p>Иванова М.М., Гусева Н.Г., Несговорова Л.И. Хронический полиартрит при диффузных болезнях соединительной ткани. В кн.: Ревматоидный артрит. Под ред. Насоновой В.А., М.,''Медицина", 1983,105-108.</p><p>Иванова М.М., Несговорова Л.И., Мылов Н.М., Насонова В.А. Lupus arthritis. Scand. J. Rheumatol. 1984, 52, 82-85.</p><p>Насонова В.А. Системная красная волчанка. М., «Медицина», 1972,41-49.</p><p>Несговорова Л. И. Суставной синдром в клинике системной красной волчанки (клинико-рентгено-морфологическое исследование). Дисс.к.м.н. М., 1964.</p><p>Шостак Н.А. Об артропатии Жакку. Тер.архив, 1995, 11, 8083.</p><p>Agnello V., ArbetterA., Ibanezde Kasep G. et al. Evidence fora subset of rheumatoid factors that cross react with DNA-histone and have a distinct cross-idiotype. J. Exp. Med., 1980, 151,15141527.</p><p>Alarcon-Segovia D., Abud-Mendoza C., Diaz-Jouanen E. et al. Deforming arthropathy of the hands in systemic lupus erythematosus. J.Rheumatol., 1988, 15, 1,65-69.</p><p>Babini S.M., Cocco М., de la Sota M. et al. Tendinous laxity and Jaccoud's syndrome in patients with SLE. Possible role of secondary hyperparsthyroidism. J. Rheumatol., 1989, 16, 4, 494498.</p><p>Bleifield C.J, Inglis A.E. The hand in systemic lupus erythematosus. J. Bone Joint Surg., 1974, 56A, 1207-1215.</p><p>Bywaters E.G.L. Jaccoud's syndrome: Today's view. Clin. Rheumatol. Pract., 1986, 4,153-155.</p><p>Bywaters E.G.L. The relation between heart and joint disease (type Jaccoyd's). Br.Heart J., 1950, 12, 101-131.</p><p>Cohen M.R., Steiner G., Smolen J.S., Isenberg DA. Erosive arthritis in systemic lupus erythematosus: analysis of a distinct clinical and serological subset. Br. J. Rheumatol., 1998, 37, 421424.</p><p>Cohen M.G., Wfebb J. Concurrence of rheumatoid arthritis and systemic lupus erythematosus: report of 11 cases. Ann.Rheum.Dis., 1976, 46, 853-858.</p><p>Cronin M.E. Musculoskeletal manifestations of systemic lupus erythematosus. Rheum. Dis. Clin. North Am., 1988, 14(1), 99116.</p><p>Cruickshank B. Lesions of joints and tendon sheaths in systemic lupus erythematosus. Ann. Rheum. Dis., 1959, 18,111-119.</p><p>Dray GJ. The hand in systemic lupus erythematosus. Hand Clin., 1989, 5, 145-155.</p><p>Esdaile J.M., DanofT D., Rosenthall L., Gutkowski A. Deforming arthritis in systemic lupus erythematosus. Ann.Rheum.Dis. 1981,40(2), 124-126.</p><p>Evans J.A., Hastings D.E., Urowits M.B. The fixed lupus hand deformity and its surgical correction. J.Rheumat., 1977, 4(2), 170-175.</p><p>Gould D.M., Daves M.L. Roentgenologic findings in SLE. An analysis of 100 cases. J.Chronic Dis., 1955,2, 136-145</p><p>Hannestad К., Rekving D.P., Husebekk A. Cross reacting rheumatoid factors and lupus erythematosus (LE) factors. Springer Semin. Immunopathol., 1981,4,133-160.</p><p>Isenberg D.A., Horsfall A. Systemic lupus erythematosus - adult onset. In: Maddison P.J. at al. Oxford textbook of rheumatology. 2nd edn. Oxford: Oxford University Press, 1998, 11451180.</p><p>Jaccoud F.S. Sur une forme de rhumatisme chronique: lecons de clinique Medicale faites a l'Hopital de la Charite. Paris: Dclahaye, 1869,598-616.</p><p>Kramer L.S., Ruderman J.E., Dubois E.L., Friou G.T. Deforming non-erosive arthritis of the hands in chronic SLE. Arthr. Rheum., 1970, 13. 329-330.</p><p>Labowitz R., Schumacher H.R.Jr. Articular manifestation of systemic lupus erythematosus. Ann.Intern.Med., 1971,74, 911 -921.</p><p>Lawless O.J., Whelton J.C. Deforming hand arthritis in systemic lupus erythematosus. [Abstr.|. Arthr.Rheum., 1974, 17, 323.</p><p>Ostendorf B., Scherer A., Specker Ch. et al. Jaccoud's arthropathy in systemic lupus erythematosus. Differentiation of deforming and erosive patterns by MRI. Arthr.Rheum., 2003, 1, 157165.</p><p>Palazzo E., Bourgeois P., Meyer O. et al. Hypo-complc- mentemic urticarial vasculitis syndrome, Jaccoud?s syndrome, valvulopathy: A new syndromic combination. J.Rheumatol., 1993, 20,1236-1240.</p><p>Reilly P.A., Evison G., McHugh N.J., Maddison P.J. Arthropathy of hands and feet in systemic lupus erythematosus. J.Rheumatol., 1990, 17, 777-784.</p><p>Russel F.S., Percy J.S., Rigal W.W., Wilson G.L. Deforming arthropathy in systemic lupus erythematosus. Ann. Rheum. Dis., 1974,33,204. ’</p><p>Spronk P.E., Ter Borg E.J., Kallenberg C.G.M. Jaccoud's arthropathy: a clinical subset with an increased C-reactive protein response. Ann.Rheum.Dis., 1992, 51,358-361.</p><p>Sturgess A.S., Littlejohn G.O. Jaccoud's arthritis and panvasculitis in the hypocomplementemic urticarial vasculitis syndrome. J.Rheumatol. 1988, 15, 858-861.</p><p>Van Vugt R.M., Derksen R.H., Kater L., Bijlsma J.W. Deforming arthropathy or lupus and rhupus hands in systemic lupus erythematosus. Ann. Rheum. Dis., 1998, 9, 540-544.</p><p>fclayos E.E., Leidholt J.D., Smyth C.J. et al. Arthropathy associated with steroid therapy. Ann. Intern. Med., 1966, 64, 759771.</p><p>Wallace D.J., Hahn B.H., Quismorio F.P., Klinenberg J.R. Duboi's lupus erythematosus. 5-th ed. Philadelphia: Lea and Fibeger, 1977,635-639.</p><p>Wfeissman B.N., Rappoport A.S., Sosman J.L., Schur P.H. Radiographic findings in the hands in patients with systemic lupus erythematosus. Radiology, 1978, 126, 313-317.</p></div><br />

The authors declare that there are no conflicts of interest present.