Autoamputation in a 45-year-old female with systemic lupus erythematosus overlap with systemic sclerosis: A case report
- Author:
Aldrich Kyne L. So
1
;
Cheryl Anne A. Dela Cruz-Tan
1
;
Jessie F. Orcasitas
1
Author Information
- Publication Type:Case Reports
- Keywords: Autoamputation; Scleroderma; Overlap Syndrome
- MeSH: Human; Female; Middle Aged: 45-64 Yrs Old; Scleroderma, Systemic; Lupus Erythematosus, Systemic
- From: Philippine Journal of Internal Medicine 2025;63(4):18-25
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are complex autoimmune conditions that can co-exist with 6.8% prevalence based on cohort studies. This case report details the clinical journey of a 45-year-old female with an SLE-SSc overlap syndrome particularly presenting with autoamputation of digits, which is a rare and debilitating complication of SSc, with a scarcity of published reports as of writing.
Case Description:This patient was diagnosed with SLE nearly a decade ago, presenting with alopecia, joint pains, malar rash, and a positive antinuclear antibody test. Initial treatment with prednisone and hydroxychloroquine showed improvement, but hydroxychloroquine was discontinued due to adverse effects. Subsequently, she developed skin tightness, deformities in her digits, and progressive vision loss, consistent with SSc, but she did not seek timely medical attention. During the COVID-19 pandemic, her symptoms worsened, leading to hand weakness, digit shortening, and loss of fingernails. She was eventually diagnosed with SSc by a rheumatologist. The patient commenced treatment with prednisone (10 mg daily) and mycophenolate mofetil (500 mg thrice daily). Six months into treatment, she showed significant improvement in skin pliability and hand functionality, with regrowth of fingernails. The patient demonstrated excellent adherence to the treatment regimen and regular follow-up visits, resulting in continued improvement in her condition.
Conclusion:SLE-SSc overlap syndromes pose diagnostic challenges due to shared clinical features. This case underscores the need for early recognition and tailored treatment strategies, as evidenced by the patient’s positive response to combined immunosuppressive therapy. Addressing these complexities requires ongoing research and interdisciplinary collaboration to optimize patient outcomes. - Full text:20260630145240066164-2024-355.pdf
