Reumatizam, Vol. 63 No. 1, 2016.
Professional paper
POLYMYOSITIS AND SYSTEMIC SCLEROSIS OVERLAP – A CASE REPORT AND A REVIEW OF THE LITERATURE
Marin Petrić
Dušanka Martinović Kaliterna
Ivona Božić
Marija Nuić,
Dijana Perković
Abstract
Polymyositis (PM) is an autoimmune disease which aff ects skeletal muscles. In young age, it usually
occurs as an idiopathic disorder associated with specifi c autoantibodies (anti-Jo), while in older age it is oft en associated
with neoplasms. It can present with symptoms of other autoimmune diseases, such as systemic sclerosis (SSc), a
rare progresive disease characterized by collagen deposits in various tissues and organs.
A 65-year-old patient, long-time smoker, came to the ER because of painful edema in the distal parts of his limbs
and proximal muscle weakness of his arms and legs. Although his muscle enzymes were not increased, PM was confi
rmed by the characteristic pathohistological fi nding. Th e patient had sclerodermal skin lesions on his back, but he did
not have other typical SSc symptoms, and the specifi c autoantibodies were negative. He received glucocorticoid therapy
(GC) aft er we had fi nished screening for malignant tumors. He felt better, his muscle strength returned, and the limb edema disappeared. Four weeks later, he developed symptoms which are more typical of SSc, such as dysphagia,
Raynaud’s phenomenon, and skin thickening of the limbs that had been swollen.
PM is oft en associated with SSc. It is not clear if the exacerbation of latent SSc was stimulated by GC, or if it was
just a simple overlap of the two diseases with diff erent onsets. Th ere are no therapy guidelines for the treatment of this
combination of diseases. Careful use of GC is necessary even if SSc symptoms are discreet, because of the well-known
eff ects of GC in SSc.
Keywords
Polymyositis – diagnosis, drug therapy, complications; Scleroderma, systemic – diagnosis, drug therapy, complications; Glucocorticoids - therapeutic use; Methylprednisolone – therapeutic use
Hrčak ID:
182808
URI
Publication date:
10.5.2016.
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