TY - JOUR T1 - Autoimmune-autoinflammatory rheumatoid arthritis overlaps: a rare but potentially important subgroup of diseases JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2017-000550 VL - 3 IS - 2 SP - e000550 AU - Sinisa Savic AU - Anoop Mistry AU - Anthony G Wilson AU - Gabriela Barcenas-Morales AU - Rainer Doffinger AU - Paul Emery AU - Dennis McGonagle Y1 - 2017/11/01 UR - http://rmdopen.bmj.com/content/3/2/e000550.abstract N2 - At the population level, rheumatoid arthritis (RA) is generally viewed as autoimmune in nature with a small subgroup of cases having a palindromic form or systemic autoinflammatory disorder (SAID) phenotype. Herein, we describe resistant cases of classical autoantibody associated RA that had clinical, genetic and therapeutic responses indicative of coexistent autoinflammatory disease. Five patients with clinically overlapping features between RA and SAID including polysynovitis and autoantibody/shared epitope positivity, and who had abrupt severe self-limiting attacks including fevers and serositis, are described. Mutations or single nucleotide polymorphisms in recognised autoinflammatory pathways were evident. Generally, these cases responded poorly to conventional Disease-modifying anti-rheumatic drugs (DMARD) treatment with some excellent responses to colchicine or interleukin 1 pathway blockade. A subgroup of RA cases have a mixed autoimmune-autoinflammatory phenotype and genotype with therapeutic implications. ER -