Management of systemic lupus erythemathous with polymyositis overlap syndrome

There has been an increase in SLE cases among children in Sanglah General Hospital. In the rare case, there is a possibility SLE occurs not as a single entity but overlap with another connective tissue disease. Polymyositis is a disease with a primary symptom of muscle weakness associated with muscle pain and swollen. Polymyositis very rarely becomes overlapping syndrome with SLE, occurring in 4-6% of SLE patients. The aim of this study is to describe clinical findings and management of SLE and Polymyositis. This case is a 12-year-old girl presented with arthralgia and myalgia since one month before admission, accompanied by a 1-month episode of relapsing fever, decrease in appetite, facial rash, photosensitivity, muscle weakness numbness and tingling sensation on the right foot. Diagnosis of SLE was based on the diagnostic criteria of the American College of Rheumatology. Neurologic examination and electromyography were significant for the decrease in motoric power on the right lower limb, gastrocnemius atrophy, steppage gait, and reduction of the sensory sensation of right L4-S1 dermatome. Hence, the diagnose of SLE and polymyositis was concluded. This is a case of SLE overlap syndrome with polymyositis. The patient was treated with prednisone 2 mg/kg/day for 2 weeks, and also given ibuprofen 10 mg/kg/dose for pain relief, continued with azathioprine plan for one year. The patient showed an excellent result with the disappearance of symptoms and normal laboratory examination. The conclusion of the study is SLE overlap syndrome with polymyositis treated with prednisone and ibuprofen continue with azathioprine showed good outcome with the disappearance of symptoms and normal laboratory examination.