Abstract Ref Number = APCP729
SYSTEMIC LUPUS ERYTHEMATHOUS WITH POLYMYOSITIS OVERLAP SYNDROME
Suryo Gading,Ketut Dewi Kumara Wati,Komang Ayu Witarini,Hendra Santoso,I Gusti Ngurah Suwarba
Department of Child Health Faculty of Medicine Udayana University Denpasar Department of Child Health, Faculty of Medicine,Udayana University Denpasar
Background : There had been an increase in SLE cases among children in Sanglah General Hospital. In rare case there is a possibility SLE occurs not as a single entity but overlap with other connective tissue. Polymyositis is a disease with a main symptom of muscle weakness associated with muscle pain and swollen. Polymyositis very rare becomes overlap syndrome with SLE, occurring in 4-6% of SLE patients.
Case Presentation Summary : A 12 year old girl presented with arthralgia and myalgia since one month before admission. Arthralgia was accompanied by a 1 month episode of relapsing fever, decrease in appetite, facial rash, photosensitivity, numbness and tingling sensation on right foot. Diagnosis of SLE was made based on the diagnostic criteria of the American College of Rheumatology. As muscle weakness is not on the list of SLE criteria, we try to do assessment base on perception manifestation possibly a different group of polymyositis. Neurologic examination was significant for decrease in motoric power on right lower limb, gastrocnemius atrophy, steppage gait, and decrease in sensoric sensation of right L4-S1 dermatome. Hence, diagnose of SLE and polymyositis was concluded. This is a case of SLE overlap syndrome with polymyositis. Patient was treated with prednisone 2 mg/kg/day for 2 weeks, and also given ibuprofen 10 mg/kg/dose for pain relief, continue with azathioprin plan for one year. Patient showed good result with disappearance of symptomp and normal laboratory examination.
Learning Points/Discussion : SLE overlap syndrome with polymyositis treated with prednison and ibuprofen continue with azathioprin. Outcome was good with disappearance of symptomp and normal laboratory examination.
Keywords: Systemic Lupus Erythematous Polymyositis Children Overlap syndrome