Overlap syndrome of juvenile dermatomyositis with systemic lupus erythematosus: A rare case report of diagnostic perplex

Abstract

AbstractIntroductionOverlap syndromes include a heterogenous group of conditions presenting with mixed features of more than one autoimmune disorder simultaneously in the same patient. Systemic lupus erythematosus (SLE) with myositis overlap is a rare scenario, particularly in the pediatric age group.Case DetailsWe describe an adolescent girl presented with photosensitivity, cutaneous ulcers, alopecia, periorbital edema, proximal muscle weakness, and digital gangrene. She was diagnosed as SLE‐juvenile dermatomyositis (DM) overlap based on overlapping clinical features, laboratory markers like anemia, significant proteinuria, hypocomplementemia, raised muscle enzymes, and positivity for antinuclear antibody, dsDNA, and anti‐Ro/anti‐SSA. Prompt treatment with combination of methylprednisolone‐cyclophosphamide pulse led to marked improvement.ConclusionOverlap syndromes are challenging in terms of diagnosis and management with unpredictable outcomes and unclear treatment guidelines.