Navigating Rhupus Complexity

The term 'Rhupus,' introduced by Peter Schur in 1971, describes patients meeting criteria for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Rhupus (RhS) is a rare syndrome, and approximately 60 cases have been described in the literature to date. The challenges in diagnosing this disease stem from the lack of well-defined clinical criteria. In this case, we present a 42-year-old female patient with overlap syndrome of RA and SLE (RhS) who developed inflammatory arthritis, swelling in her bilateral wrists, severe malar rash, oral ulcers and alopecia, anemia and thrombocytopenia during follow-up. Upon arrival, the patient’s laboratory values were as follows: erythrocyte sedimentation rate: 61 mm/hour (normal value: 0-20), hemoglobin: 8.3 g/dL (12-16), platelet count: 112.103/µL (150-450.103/µL). The purpose of documenting this case is to share our own experience with a syndrome that is quite rare and has the potential to cause confusion in the daily practice of clinicians.