The coexistence of systemic sclerosis and rheumatoid arthritis in five patients. Clinical and immunogenetic features suggest a distinct entity

✍ Scribed by Terumi Horiki; Junko Moriuchi; Masatoshi Takaya; Mitsuaki Uchiyama; Yuichi Hoshina; Kenichi Inada; Hidetoshi Inoko; Kmiyoshi Tsuji; Yukinobu Ichikawa

• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 389 KB
• Volume: 39
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780390121

✦ Synopsis

To elucidate the clinical characteristics and pathogenesis of scleroderma-rheumatoid arthritis (SSc-RA) overlap syndrome, we analyzed the clinical features of 5 patients with SSc-RA overlap. Their HLA phenotypes and genotypes were also determined. Generalized skin sclerosis, severe seropositive polyarthritis, pulmonary fibrosis, anti-topoisomerase I antibodies, and HLA-DR4,53;DQA1*0301;DQBl*O4 haplotype were observed in all of the patients. Similar clinical features were recognized in most of the 10 cases reported previously. Our case studies indicate that SScRA overlap may be a distinct entity.

Antinuclear antibodies (ANA) are frequently found in sera from patients with systemic sclerosis (SSc), and it has been suggested that different types of ANA relate to various clinical subsets of the disease (1). Anticentromere antibodies are primarily detected in patients with limited cutaneous involvement, whereas antibodies to DNA topoisomerase I (anti-top0 I) identify a subset of patients with more extensive involvement, including skin and internal organs (2). The molecular mechanism underlying the development of SSc is unknown, but several immunoge-