Polymyosis-Sclerosis Overlap Syndrome. Case report and review of literature

Authors

  • Rocío Beatriz Fonseca Muñoz Universidad de Ciencias Médicas “Mariana Grajales” de Holguín. Cuba
  • Maricarmen González Costa Instituto de Ciencias Básicas y Preclínicas Victoria de Girón
  • Alexander Ariel Padrón González Instituto de Ciencias Básicas y Preclínicas Victoria de Girón

Keywords:

overlapping syndrome, superposition syndrome, polymyositis, scleroderma

Abstract

Introduction: In the syndrome of overlap or overlap there are simultaneously clinical or serological manifestations of two or more systemic autoimmune diseases. They affect 5% of the population with predominance in women.
Case Presentation: A 48-year-old man with no personal pathological history. He came with pain in both hands, inflammation in the metacarpal and interphalangeal proximal joints, bilateral and symmetrical, accompanied by morning stiffness that lasted almost all day for 4 months. He was diagnosed with rheumatoid arthritis and started treatment that he abandoned. Then a picture appears that is interpreted as an overlap so it is entered with a florid clinical picture. In laboratory tests: transaminases, creatine phosphokinase, lactate dehydrogenase, were elevated. Clinical and complementary diagnosis of Polymyosis-Sclerosis Overlap Syndrome was diagnosed. Treatment with immunosupers was started. The patient evolved unfavorably and died.
Discussion: The diagnosis of this case was made by clinical manifestations such as sclerodermic fascia, salt and pepper sign, predominantly distal fibrosis in both hands, perioral telangiectasias. Differential diagnoses are systemic autoimmune diseases when presented as single frames. First-line treatment and prognosis depend on overlapping diseases.

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References

Duró Pujol JC. Reumatología clínica. Barcelona. Editorial Elsevier; 2010; p219

Rojas W, Anaya JM, Cano LE, Aristizábal BH, Gómez LM, Lopera D. Inmunología de Rojas. 17ma Ed. Medellín. Editorial Fondo CIB; 2015; p465-474

Jury EC, D'Cruz D, W Morrow WJ. Autoantibodies and overlap syndromes in autoimmune rheumatic disease. Group Ltd & Association of Clinical Pathologists. [Internet]. 2017. [citado 18 Feb 2018]; 0021-9746. Disponible en: http://jcp.bmj.com/content/54/5/340

Sharp GC, Irwin WS, Tan EM, Gould RG, Holman HR. Mixed connective tissue disease: an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med. [Internet]. 2015. [citado 18 Feb 2018] 1972;52:148-59. Disponible en: https://www.amjmed.com/article/0002-9343(72)90064-2/fulltext

Lockshin MD, Levine AB, Erkan D. Patients with overlap autoimmune disease differ from those with ‘pure’ disease. Lupus Sci Med. [Internet]. 2015. [citado 18 Feb 2018]; 2(1): e000084. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422903/

Moinzadeh P, Aberer E, Ahmadi-Simab K, Blank N, W Distler JH, et al. Disease progression in systemic sclerosis-overlap syndrome is significantly different from limited and diffuse cutaneous systemic sclerosis. Ann Rheum Dis. [Internet]. 2015. [citado 18 Feb 2018]; 74(4): 730–737. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392314/

Alba Fériz R, Muñoz Louis R, R. Espinoza L, Khamashta M, Matucci-Cerinc, Sanmartí R, editores. Enfermedades Inflamatorias Reumatológicas. Panamerican League of Associations for Rheumatology: Editorial Producciones Científica Ltda; 2016

Alarcón-Segovia D, Molina L. J, editors. Tratado hispanoamericano de Reumatología. Vol 2. Bogotá: Editorial Nomos; 2007; p918

Larrauri Blas J, Fernández Romero DS, Juri MC, Malbrán A. Miopatías inflamatorias con evolución recidivante. Medicina (B. Aires) [Internet]. 2016 [citado 10 Jul 2018]; 76( 6 ): 379-382. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802016000600012&lng=es

Cappelli S, Bellando-Randone S, Guiducci S, Matucci-Cerinic. Is Immunossuppressive therapy the anchor treatment to achieve remission in systemic sclerosis? Rheumatology Oxford. [Internet]. ? 2014 [citado 10 Jul 2018].; 53(6): 975-87. https://academic.oup.com/rheumatology/article/53/6/975/1824450

Pakozdi A, Nihtyanova S, Moinzadeh P, et al. Clinical and serological hallmarks of systemic sclerosis overlap syndromes. J Rheumatol. [Internet]. 2011. [citado 18 Feb 2018]; 38:2406–9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21844148

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Published

2019-07-11

How to Cite

1.
Fonseca Muñoz RB, González Costa M, Padrón González AA. Polymyosis-Sclerosis Overlap Syndrome. Case report and review of literature. Rev. cuba. de Reumatol. [Internet]. 2019 Jul. 11 [cited 2026 Jan. 16];21(1 Supp. 1):e61. Available from: https://revreumatologia.sld.cu/index.php/reumatologia/article/view/646

Issue

Vol. 21 No. 1 Supp. 1 (2019): January-April

Section

Studies of cases

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