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Unusual overlap of systemic sclerosis with Takayasu arteritis
  1. Anoop Chithrabhanu,
  2. Arul Rajamurugan Ponniah Subramanian,
  3. Ramesh Ramamoorthy and
  4. Mythili Seetharaman Varadhan
  1. Institute of Rheumatology, Madras Medical College, Chennai, Tamil Nadu, India
  1. Correspondence to Dr Anoop Chithrabhanu; anooppaloor{at}gmail.com; Professor Arul Rajamurugan Ponniah Subramanian; arulrajamurugan{at}gmail.com

Abstract

Overlap syndromes are diseases that meet the criteria of two or more rheumatic diseases. In this case report, a woman in her 20s presented with a constellation of symptoms, including skin thickening, Raynaud’s phenomenon, hypertension, absent pulse in both lower limbs with bilateral renal artery bruit. The antinuclear antibody profile revealed Scl-70 positivity. CT thorax identified early interstitial lung disease, and nailfold capillaroscopy showed severe capillary loss. CT angiogram features were suggestive of Takayasu arteritis. Notably, there have been only four documented cases of systemic sclerosis coexisting with Takayasu arteritis, highlighting the rarity of this overlap syndrome. The diagnosis of overlap syndrome was made after a thorough history recording and clinical examination. In the presence of bilateral renal artery stenosis, managing the scleroderma renal crisis may be challenging . This patient received treatment with mycophenolate mofetil and oral corticosteroids, aiming to address both systemic sclerosis and Takayasu arteritis effectively.

  • Vasculitis
  • Connective tissue disease
  • Hypertension

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Footnotes

  • Twitter @anooppaloor

  • Contributors AC, ARPS, RR and MSV were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. ARPS gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.