title: Overlap connective tissue disease syndromes.
abstract: Overlap Syndromes (OSs) have been defined as entities satisfying classification criteria of at least two connective tissue diseases (CTDs) occurring at the same or at different times in the same patient. CTDs include systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), polymyositis/dermatomyositis (PDM), and Sjögren syndrome (SS). Every combination between these disorders has been reported. In some OS a specific autoantibody has been indentified, supporting the hypothesis that these syndromes are not a mere association of two or more CTD in the same patient, but a well defined clinical entity with specific clinical characteristics. As an example, anti-t-RNA synthetase syndrome is characterized by the presence of anti-t-RNA synthetase antibodies. Notably, clinical manifestations observed in OS may be different from those observed in the single CTD. The treatment of OS is mainly based on the use of corticosteroids and immunosuppressants. Biologic drugs, i.e. anti-TNFα or anti-CD20 monoclonal antibodies, have been recently introduced as alternative treatments in refractory cases. Moreover, there are some concerns with the use of anti-TNF agents in patients with systemic autoimmune diseases due to the risk of triggering disease exacerbations. In this paper the most frequent OS are described with a special focus on the specific immunologic and clinical aspects. Furthermore, some personal data on anti-t-RNA synthetase syndrome and rhupus syndrome are reported.
authors: Division of Rheumatology, Department of Medicine, University of Padua, Italy.
authors: Luca
authors: L
authors: Iaccarino
authors: Mariele
authors: M
authors: Gatto
authors: Silvano
authors: S
authors: Bettio
authors: Francesco
authors: F
authors: Caso
authors: Mariaelisa
authors: M
authors: Rampudda
authors: Margherita
authors: M
authors: Zen
authors: Anna
authors: A
authors: Ghirardello
authors: Leonardo
authors: L
authors: Punzi
authors: Andrea
authors: A
authors: Doria
mesh_terms: D001323:Autoantibodies / Q000097:blood; D003240:Connective Tissue Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans
chemical_list: D001323:Autoantibodies