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Case Reports in Rheumatology
Volume 2013, Article ID 819629, 4 pages
Case Report

RHUPUS Syndrome in Children: A Case Series and Literature Review

1Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
2Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
3Division of Pediatric Rheumatology, Children's Medical Center, Pediatrics Center of Excellence, Tehran 14194, Iran
4Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran

Received 24 March 2013; Accepted 21 April 2013

Academic Editors: H. Alexanderson, C. Orellana, and G. J. Tsay

Copyright © 2013 Vahid Ziaee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Overlap of juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) is a rare clinical condition in children. This condition has been described as RHUPUS syndrome. Prevalence of this syndrome and 3 cases are reported in this paper. Cases Presentation. During 10 years, 3 patients with SLE had chronic arthritis before or after diagnosis of SLE. Prevalence of this disorder in JSLE was 2.5%. Two patients were females and one of them was a male. According to our review, mean delay between chronic joint involvement and JSLE diagnosis was 50.1 months. In our case report, two females had joint erosion and one of them died due to heart failure, but in the literature review, just 45% cases had joint erosion and 70% cases were polyarticulare form. Conclusion. RHUPUS is unusual presentation of lupus in children. It seems that clinical feature and outcome of RHUPUS syndrome are different in children due to difference between RA and JIA. We suggest juvenile RHUPUS for overlap of JIA and JSLE.