title: A dermatomyositis and scleroderma overlap syndrome with a remarkable high titer of anti-exosome antibodies.
abstract: An overlap syndrome of dermatomyositis and scleroderma is reported. The case corresponded to a 27-year-old female with a clinical picture of 14 months evolution, characterized by proximal muscles weakness, erythematous rash in wrists, knees, ankles, Gottron sign, heliotrope periorbital rash and dysphagia. A muscle biopsy was compatible with dermatomyositis; meanwhile the skin biopsy was compatible with scleroderma. Muscle enzymes were increased. Interestingly, the antinuclear antibody determination in HEp-2 cells was positive with a remarkable titer of 81,920 exhibiting a nucleolar pattern. Anti-Jo1 antibody was negative, but anti-PM/Scl-100 positive. The patient received methylprednisolone and cyclophosphamide pulses, with gradual improvement. Present report constitutes a case of overlap dermatomyositis-scleroderma syndrome, with anti-PM/Scl autoantibodies (anti-exosome). The remarkable of this case was the exceptional high antinucleolar antibody titer.
authors.affiliation: Department of Immunology, Centro de Biología Experimental, Universidad Autónoma de Zacatecas, Zac. 98040, México.
authors.forename: R
authors.initials: R
authors.lastname: Gutiérrez-Ramos
authors.forename: V
authors.initials: V
authors.lastname: Gonz Lez-Díaz
authors.forename: M G
authors.initials: MG
authors.lastname: Pacheco-Tovar
authors.forename: A
authors.initials: A
authors.lastname: López-Luna
authors.forename: E
authors.initials: E
authors.lastname: Avalos-Díaz
authors.forename: R
authors.initials: R
authors.lastname: Herrera-Esparza
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D003882:Dermatomyositis / Q000097:blood* / Q000276:immunology; D055354:Exosomes / Q000276:immunology*; D005260:Female; D006801:Humans; D012595:Scleroderma, Systemic / Q000097:blood* / Q000276:immunology; D013577:Syndrome
chemical_list: D001323:Autoantibodies