Objectives The objective of this paper is to perform an ultrasonography (US) analysis of hands and wrists in two groups of patients with systemic lupus erythematosus (SLE), with and without Jaccoud's arthropathy, matched by age and disease duration and to correlate them with levels of CXCL13 clinical features, laboratory tests and disease activity score. Methods Sixty-four patients with SLE were enrolled, 32 with and 32 without Jaccoud's arthropathy. Each patient underwent physical examination, laboratory tests (including CXCL13 by ELISA) and bilateral US. Synovial hypertrophy, tenosynovitis and erosions were evaluated according to a semiquantitative grading system with a 0-3 rating. US findings were correlated with serum levels of CXCL13, other serological parameters and disease activity index. Results Synovitis was found in 25/64 patients (39%) and tenosynovitis in 14/64 (22%). These findings were more frequent in SLE patients with Jaccoud's arthropathy, particularly tenosynovitis ( p = 0.002) and synovitis ( p = 0.01). Median serum level of CXCL13 was 20.16 pg/ml in the whole population (23.21 pg/ml in the Jaccoud's arthropathy group and 11.48 pg/ml in the group without). There was an association between the presence of disease activity and high level of CXCL13 ( p = 0.004). However, no association was found between high levels of CXCL13 and "arthritis" in SLEDAI, swollen joints on physical examination or synovitis on US. Conclusions US findings in joints of SLE patients with Jaccoud's arthropathy confirm that synovitis and tenosynovitis are common in these patients. In addition, serum level of CXCL13 is associated with disease activity in SLE but does not seem to be a biomarker for arthritis in these patients.

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease that can present, as other collagen vascular disorders, changes in blood vessels. It can be evaluated by a non-invasive technique called periungual nailfold videocapillaroscopy (VCP). This technique is helpful in the diagnosis of systemic sclerosis (SSc), being part of the new classification criteria, and identifies individuals with Raynaud's phenomenon who are at a higher risk for developing SSc.ObjectivesThis study aims to describe the videocapillaroscopic profile of a series of SLE patients and investigate if the VCP pattern is different among those with Jaccoud's arthropathy (JA) compared to the patients without this complication.MethodsThe patients were submitted to VCP, clinical evaluation, and laboratory tests. The capillaroscopic patterns were defined as minor, major and scleroderma (SD). The presence of capillaroscopic findings such as elongated capillaries, increased tortuosity, ectasia, prominent venous plexus, neoangiogenesis, hemorrhage and megacapillaries was also observed.ResultsIn a population of 113 female patients with SLE (67 without JA and 46 with JA), at least one alteration was observed in VCP in 89.40% of patients, and the “nonspecific changes” were the most prevalent. Minor changes were seen in 39 (58.2%) and 26 (56.5%) patients, and major changes were seen in 21 (31.3%) and 11 (23.9%) patients without and with JA, respectively. The SD patterns were observed in 02 (3.0%) and 03 (6.5%) patients without and with JA, respectively (p>0.05).ConclusionsThe majority of patients of SLE present changes in the VCP exam, but such a tool does not allow distinguish those with or without JA.References Lambova SN, Muller-Ladner U. Capillaroscopic pattern in systemic lupus erythematosus and undifferentiated connective tissue disease: what we still have to learn? Rheumatology international. 2013;33(3):689–95.Ingegnoli F. Capillaroscopy abnormalities in relation to disease activity in juvenile systemic lupus erythematosus. Microvascular research. 2013;87:92–4. Santiago MB, Galvao V. Jaccoud arthropathy in systemic lupus erythematosus: analysis of clinical characteristics and review of the literature. Medicine. 2008;87(1):37–44.Ingegnoli F, Zeni S, Meani L, Soldi A, Lurati A, Fantini F. Evaluation of nailfold videocapillaroscopic abnormalities in patients with systemic lupus erythematosus. Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases. 2005;11(6):295–8.Ragab O, Ashmawy A, Abdo A, Mokbel A. Nailfold capilloroscopy in systemic lupus erythematosus. The Egyptian Rheumatologist. 2011;33:61–7. AcknowledgementsM. B.S. has received a scholar ship from Conselho Nacional de Desenvolvimento Científico e Tecnolόgico (CNPq).Disclosure of InterestNone declared