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A Filipino with systemic lupus erythematosus-scleroderma overlap syndrome.


Kristian Anteolin  D. Punzalan,
Patrick  Y. Siy,
Engelbert Simon  S. Perillo,
Lorielle Marie  E. Galvez,
Sandra Tankeh-Torres,
Philip  U. Chua

Related Institution

Department of Internal Medicine - Cardinal Santos Medical Center

Section of Rheumatology, Department of Internal Medicine, - Cardinal Santos Medical Center

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Publication Information

Publication Type
Publication Sub Type
Case report
Philippine Journal of Internal Medicine
Publication Date
July-September 2015


BACKGROUND: Overlap syndrome is a large group of condition that manifests with symptoms from two or more autoimmune conditions and satisfies the diagnostic criteria of at least two connective tissue diseases in the same patient. This condition might be unrecognized by the primary care physician and underreported.
CASE: A 30-year-old female had a 10-week history of non-pruritic erythematous macules on her face that gradually spread to her trunk, and upper extremities which progressed to hyperpigmented macules and tightening of the skin. There was note of hair loss, anemia, ulcerating wounds on distal extremities and finger tips. She then developed generalized body weakness and easy fatigability. Physical and laboratory examinations were consistent with SLE and scleroderma. 2D-echocardiogram showed a large pericardial effusion and pulmonary hypertension. She was treated with prednisone and azathioprine which in less than a week, diminished significantly the pericardial effusion. Patient also complained of a few day history of unilateral blurring of vision which turned out to be central retinal artery occlusion.
CONCLUSION: Overlap syndrome is a disease entity to consider in patients with multiple symptoms that cannot be classified into one connective tissue disease. Treatment of this disease should be individualized and based on the connective tissue diseases involved.

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