J Rheum Dis.  2019 Oct;26(4):282-285. 10.4078/jrd.2019.26.4.282.

A Rare Case of Overlap Syndrome with Diffuse Systemic Sclerosis, Rheumatoid Arthritis, and Cutaneous Sarcoidosis

• Ko KM
• Moon SJ
• Koh JH
• Kim J
• Min JK

• KMID: 2459454
• DOI: http://doi.org/10.4078/jrd.2019.26.4.282

Abstract

Overlap syndrome is defined as a disease entity that satisfies the classification criteria of at least two connective tissue diseases occurring concurrently or separately in a single patient. Here, we report a rare case of a 59-year-old woman with diffuse systemic sclerosis with lung involvement-rheumatoid arthritis overlap syndrome accompanied by cutaneous sarcoidosis. Although there is no consensus for the optimal treatment of overlap syndrome to date, this case of co-existing rheumatoid arthritis and systemic sclerosis with interstitial lung disease successfully responded to abatacept.

Keyword

Undifferentiated connective tissue diseases; Systemic sclerosis; Rheumatoid arthritis; Sarcoidosis

MeSH Terms

Abatacept
Arthritis
Arthritis, Rheumatoid*
Classification
Connective Tissue Diseases
Consensus
Female
Humans
Lung
Lung Diseases, Interstitial
Middle Aged
Sarcoidosis*
Scleroderma, Diffuse*
Scleroderma, Systemic
Abatacept

Figure

• 

  Figure 1 Skin biopsy demonstrated chronic granulomatous inflammation with multinucleated giant cells (arrows) in the dermis of the forearm (H&E stain, original magnification: (A) ×40; (B) ×400).

• 

  Figure 2 Hand radiographs revealed no obvious articular destruction or erosions at the time of diagnosis (A), but marked articular destruction and erosions were observed five years later (B).

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