Síndrome de superposición entre Esclerosis Sistémica y Lupus Eritematoso Sistémico: A propósito de un caso

Abstract

BACKGROUND: Regarding autoimmune diseases, an overlap syndrome is defined as one that meets satisfactory inclusion criteria for two different connective tissue diseases at the same time. SLE is one of the most well-known and studied autoimmune pathologies, its overlap with other autoimmune diseases is known, being one of the least frequent its association with Systemic Sclerosis (SS). Here we present a case of SLE-SS overlap, which was diagnosed many years after the onset of symptoms. CASE REPORT: A 45-year-old female patient, diagnosed 14 years ago with Sjogren's Syndrome and Raynaud's Syndrome, without current treatment. She came to receive medical attention due to asthenia, a feeling of shortness of breath, erythema in the toes, joint pain in the distal interphalangeal joints of both hands, and lesions in the fingernails. After assessing the clinical features and with the help of complementary tests, mixed connective tissue syndrome was ruled out. The patient met the diagnostic criteria for SLE (2019 ACR/EULAR criteria) and SS (2013 ACR/EULAR criteria). EVOLUTION: After confirming the diagnosis of SLE-ES Overlap Syndrome, specific treatment with immunosuppressive drugs was started, to which the patient responded favorably, with progressive improvement of her symptoms, as well as improvement in clinical laboratory parameters. CONCLUSION: Overlapping syndromes, such as ES-SLE, are rarely poorly diseases; the diagnostic suspicion should be based on symptoms compatible with both diseases simultaneously and should be confirmed by antibody determination and supported with other complementary tests. Management will be guided by the specific clinical features of the patient and the prognosis will depend on the severity of the diseases, more than on the association of them.