» Articles » PMID: 38841030

A Case of Overlapping Autoimmune Syndrome

Overview
Journal Cureus
Date 2024 Jun 6
PMID 38841030
Authors
Affiliations
Soon will be listed here.
Abstract

Overlapping autoimmune disorders are used to describe the coexistence of more than one autoimmune disease in the same patient. Mixed connective tissue disease (MCTD) and anti-synthetase syndrome (ASS) are autoimmune diseases that manifest with pulmonary involvement, presenting as persistent dyspnea. The coexistence of both conditions in the same patient is extremely rare. We herein report a case of a 44-year-old female who was diagnosed with MCTD with features of ASS (anti-Jo-1 antibody) in the setting of rheumatoid arthritis (anti-cyclic citrullinated peptide (anti-CCP) antibody), which shows temporary breathing improvement following treatment with corticosteroid and mycophenolate mofetil. However, after the completion of mycophenolate mofetil, she was found to be anti-Jo-1 antibody negative and anti-CCP antibody positive. Our case emphasizes the need to recognize overlapping autoimmune conditions in patients with complex clinical features and presentations with the immediate application of a comprehensive diagnostic approach and tailored treatment strategies. Early diagnosis and aggressive treatment are crucial for achieving remission and preventing organ damage.

References
1.
Poupon R . Autoimmune overlapping syndromes. Clin Liver Dis. 2003; 7(4):865-78. DOI: 10.1016/s1089-3261(03)00092-8. View

2.
Ruegg C, Maurer B, Laube I, Scholtze D . Jo1-antisynthetase syndrome and severe interstitial lung disease with organising pneumonia on histopathology with favourable outcome on early combined treatment with corticosteroids, mycophenolate mofetil and rituximab. BMJ Case Rep. 2019; 12(9). PMC: 6747926. DOI: 10.1136/bcr-2019-231006. View

3.
Witt L, Curran J, Strek M . The Diagnosis and Treatment of Antisynthetase Syndrome. Clin Pulm Med. 2016; 23(5):218-226. PMC: 5006392. DOI: 10.1097/CPM.0000000000000171. View

4.
Sieradzka A, Naccini B, Fontana M . A Case of Anti-Synthetase Syndrome Successfully Treated with Mycophenolate Mofetil and Rituximab but No Corticosteroids. Eur J Case Rep Intern Med. 2022; 9(7):003324. PMC: 9426970. DOI: 10.12890/2022_003324. View

5.
Ungprasert P, Crowson C, Chowdhary V, Ernste F, Moder K, Matteson E . Epidemiology of Mixed Connective Tissue Disease, 1985-2014: A Population-Based Study. Arthritis Care Res (Hoboken). 2016; 68(12):1843-1848. PMC: 5426802. DOI: 10.1002/acr.22872. View