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The concurrence of rheumatoid arthritis and limited systemic sclerosis: Clinical and serologic characteristics of an overlap syndrome

“…Overlap diseases of RA and SSc have been reported previously, but in most of those patients, scleroderma was not limited and, in contrast to the 3 patients reported herein, antibodies to topoisomerase, but not to centromere antigens, were detected (5,(12)(13)(14)(15)(16)(17)(18)(19). Raynaud's phenomenon had developed between 14 years before and 16 years after the occurrence of arthritis.…”

“…While the RA component was long-lasting and severe, the lcSSc component of the overlap disease occurred later, was mild, did not involve vital organs, and did not necessitate aggressive therapy. Thus, in contrast with other RA-scleroderma overlap patients (5,(12)(13)(14)(15)(16), the evolution of lcSSc in RA patients does not appear to constitute a bad prognostic sign.…”

“…After the original report by Sharp ct a1 on mixed connective tissuc disease (MCTD) ( l ) , many more overlap syndromes have been dcscribed. Somc arc relatively common, such as overlaps of rheumatoid arthritis (RA) with systemic lupus erythematosus (SLE) (2) or concurrence of RA and othcr rheumatic diseascs with "secondary" Sjiigren's syndromc ( 3 ) , whcrcas 0thers are relatively rare (4,5). In addition to thc typical clinical fcatures, many connective tissue discascs arc characterized by autoantibodies to nucleic acids (antinuclear antibodies; ANA) or to nuclcic acid binding proteins.…”

“…Recently, 5 cases of an overlap of SSc and RA have been reported (5). These patients had generalized sclerosis of the skin, severe seropositive RA, pulmonary fibrosis, and anti-topoisomerase I antibodies, associated with HLA-DR4 and -DR53.…”