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CASE REPORT
Diagnostic problems in a patient with pulmonary fibrosis and soft tissue calcifications: scleromyositis
 
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Submission date: 2013-10-01
 
 
Final revision date: 2013-11-06
 
 
Acceptance date: 2013-11-18
 
 
Online publication date: 2013-12-24
 
 
Publication date: 2013-12-20
 
 
Reumatologia 2013;51(6):471-473
 
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ABSTRACT
Overlap syndromes are a spectrum of disorders with mixed clinical features of different connective tissue diseases, which often make the diagnostic process difficult. The article describes the case of a 57-year-old woman with arthralgia, interstitial lung disease and soft tissue calcifications. Despite the absence of any typical skin lesions, predominant clinical features of pulmonary fibrosis and vascular changes in the nailfold capillaroscopy were strongly suggestive of scleroderma-like syndrome. During the course of the disease, six months later, laboratory tests revealed elevated creatine phosphokinase and electromyography confirmed features of primary muscle damage. Since muscle involvement and soft tissue calcifications might be characteristic for scleromyositis, a cutaneous-muscular biopsy was performed to confirm the diagnosis. We speculate that early development of calcifications in this case could be accelerated by vitamin D deficiency and secondary hyperparathyroidism. Small doses of glucocorticosteroids, azathioprine and supplementation of vitamin D were sufficient to control clinical symptoms of the disease.
REFERENCES (10)
1.
Jablonska S, Blaszczyk M. Scleromyositis: a scleroderma/polymyositis overlap syndrome. Clin Rheumatol 1998; 17: 465-467.
 
2.
Marguerie C, Bunn CC, Copier J, et al. The clinical and immunogenetic features of patients with autoantibodies to the nucleolar antigen PM/Scl. Medicine (Baltimore) 1992; 71: 327-336.
 
3.
Jablonska S, Blaszczyk M. Scleroderma overlap syndromes. Adv Exp Med Biol 1999; 455: 85-92.
 
4.
Amigues JM, Cantagrel A, Abbal M, Mazieres B. Comparative study of 4 diagnosis criteria sets for mixed connective tissue disease in patients with anti-RNP antibodies. J Rheumatol 1996; 23: 2055-2062.
 
5.
Brouwer R, Vree Egberts WT, Hengstman GJ, et al. Autoantibodies directed to novel components of the PM/Scl complex, the human exosome. Arthritis Res 2002; 4: 134-138.
 
6.
Ranque B, Bérezné A, Le-Guern V, et al. Myopathies related to systemic sclerosis: a case-control study of associated clinical and immunological features. Scand J Rheumatol 2010; 39: 498-505.
 
7.
Allanore Y, Meune C, Kahan A. Systemic sclerosis and cardiac dysfunction: evolving concepts and diagnostic methodologies. Curr Opin Rheumatol 2008; 20: 697-702.
 
8.
Smith R, Stern G. Muscular weakness in osteomalacia and hyperparathyroidism. J Neurol Sci 1969; 8: 511-520.
 
9.
Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr 2002; 75: 611-615.
 
10.
Pachman LM, Veis A, Stock S, et al. Composition of calcifications in children with juvenile dermatomyositis. Arthritis Rheum 2006; 54: 3345-3350.
 
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ISSN:0034-6233
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