Why Early Diagnosis Is the Only Hope in Overlap Syndrome

Abstract

Overlap syndrome is a rare entity which is used to describe a condition when two or more autoimmune diseases occur in a same patient . Due to the ill defined progression of the disease and the symptoms which are not true to one disease, it is usually missed.The aim of this clinical case report is to highlight this unusual disease to avoid incorrect diagnosis.A 26 year old female presented to the hospital with symptoms of joint stiffness. She demonstrated symptoms including almost all the organ systems of her body, pointing towards the possibility of an autoimmune disease.She  had  physical deformities characteristic of rheumatoid arthritis; parotid swelling and inability to open mouth commonly found in sjogren syndrome; and cardiomegaly along with pulmonary hypertension indicative of systemic sclerosis.Various laboratory tests and ultrasound were also done in this patient. However,the confirmation of presence of more than one autoimmune disease in this patient was given my serological reports .At last ,a clinical diagnosis of overlap syndrome was made. Treatment in such patients is in accordance to the presenting symptoms, but as in this patient the risk vs the benefit ratio was very high, therefore our treatment was limited only to the conservative part. Hence,tendenoplasty and physiotherapy was done.  Unfortunately she died in ICU due to right ventricular failure.We conclude that in diseases like overlap syndrome which are at first hard to diagnose and if diagnosed impossible to reverse ,early presentation and early treatment is the only hope.