Abstract
Pericarditis is a well-known complication of autoimmune diseases. We report a case of overlap syndrome of systemic scleroderma, systemic lupus erythematosus and Sjögren's syndrome with digital gangrene and significant peripheral effusion. A female in her 60s was diagnosed with systemic lupus erythematosus by her doctor in 1990. Raynaud's symptom appeared from 2010. Swelling of the fingers and progressive digital gangrene developed in May 2016, and she visited our clinic in October. She was diagnosed with overlap syndrome of systemic scleroderma, systemic lupus erythematosus and Sjögren's syndrome. Systemic edema and significant pericardial effusion with hypocomplimentemia occurred in February 2017. Pulse intravenous steroid therapy with 500mg of methylprednisolone for three days and high-dose oral prednisolone were administered because these symptoms were considered to be due to acute exacerbation of systemic lupus erythematosus. Although pericarditis improved, the digital gangrene was aggravated. High-dose steroids markedly improved pericarditis, but they may have been one of the factors that exacerbated digital gangrene caused by systemic scleroderma. Appropriate treatments should be chosen after careful consideration of the pathology of overlap syndrome.Skin Research, 17: 173-180, 2018
