Annals of medicine and surgery (2012) · 2026
Early recognition and successful management of dermatomyositis-systemic lupus erythematosus overlap syndrome: case study of a young adult.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Shivashankar Trisha, Ahmed Mohammed Faizan, Asim Summaiah, Mhaoesh Doha Mahmoud, Singh Akanksha, Mariyam Nida, Sangwan Aayush, Andanappa Adithya, Kukunoor Hanisha Reddy, Mateen Mohammed Abdul, Hamza Abdel Ghani Mohamed Esraa
Аннотация
INTRODUCTION AND IMPORTANCE: An overlap syndrome is a condition when there is coexistence of two or more autoimmune connective tissue disease, which is very rare and diagnostically challenging. Dermatomyositis is an autoimmune condition that presents with skin manifestations, progressive muscular weakness, and inflammation. Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune condition mainly affecting skin, joints, kidneys, and brain. Early recognition and therapeutic intervention are necessary in overlap syndromes to prevent the patient from having severe cardiopulmonary problems.
CASE PRESENTATION: This is a case of a 32-year-old woman diagnosed with SLE who developed progressive muscle weakness (3/5 strength proximally) and a distinctive rash, classic signs of dermatomyositis from last 2 months. Laboratory tests have shown elevated creatine kinase (3500 U/l), positive ANA (1:640), anti-dsDNA, and anti-Jo-1 antibodies, along with visible myopathic alterations on electromyographs; unique results on muscle and skin biopsies were all confirmed by investigations.
CLINICAL DISCUSSION: After confirming the diagnosis of dermatomyositis, the patient condition was managed by high dose corticosteroids (prednisolone 1 mg/kg/day), intravenous immunoglobulin for severe muscle weakness, methotrexate, high-dose corticosteroids, and physical therapy.
CONCLUSION: This case highlights the complexity of diagnosis in distinguishing the true dermatomyositis from SLE associated inflammatory myopathy in young adults. It emphasizes the importance of early recognition of DM-SLE overlap syndrome through targeted investigations integrating clinical, serological, and histopathological assessment; that can alter the disease trajectory. The case emphasizes the importance of maintaining high clinical suspicion in patients with autoimmune diseases while guiding the immunosuppressive therapy.
CASE PRESENTATION: This is a case of a 32-year-old woman diagnosed with SLE who developed progressive muscle weakness (3/5 strength proximally) and a distinctive rash, classic signs of dermatomyositis from last 2 months. Laboratory tests have shown elevated creatine kinase (3500 U/l), positive ANA (1:640), anti-dsDNA, and anti-Jo-1 antibodies, along with visible myopathic alterations on electromyographs; unique results on muscle and skin biopsies were all confirmed by investigations.
CLINICAL DISCUSSION: After confirming the diagnosis of dermatomyositis, the patient condition was managed by high dose corticosteroids (prednisolone 1 mg/kg/day), intravenous immunoglobulin for severe muscle weakness, methotrexate, high-dose corticosteroids, and physical therapy.
CONCLUSION: This case highlights the complexity of diagnosis in distinguishing the true dermatomyositis from SLE associated inflammatory myopathy in young adults. It emphasizes the importance of early recognition of DM-SLE overlap syndrome through targeted investigations integrating clinical, serological, and histopathological assessment; that can alter the disease trajectory. The case emphasizes the importance of maintaining high clinical suspicion in patients with autoimmune diseases while guiding the immunosuppressive therapy.