Abstract
Multiple sclerosis (MS) has been increasingly reported in association with other autoimmune diseases not primary affected the nervous system. The coexistence of MS and systemic sclerosis (SSc) has been rarely described. We report here the case of a 46-year-old female patient with longstanding MS since the age of 26, who developed SSc 12 years later. Her MS was of the relapsing-remitting type, but the definite diagnosis was not made until the age of 33. MS diagnosis was based on medical history, magnetic resonance imaging (MRI) studies and positive cerebrospinal fluid analysis. One year after the diagnosis of MS, she developed Raynaud’s phenomenon, skin tightness and hypopigmented patches, suggestive of scleroderma. Further investigation with laboratory studies, including serology, hand and chest X-rays, and chest computerized tomography scan confirmed the SSc diagnosis. Our report highlights the interesting association between MS and SSc that may be due to an overlapping pathogenetic mechanism for both processes.
References
Kinnunen E, Jarvinen P, Ketonen L, Sepponen R (1993) Co-twin control study on cerebral manifestations of systemic lupus erythematosus. Acta Neurol Scand 88(6):422–426
Mpofu S, Moots RJ (2003) A case of multiple sclerosis associated with rheumatoid arthritis and positive anticardiolipin antibodies. Ann Rheum Dis 62(4):376
Black CM (1993) Scleroderma—clinical aspects. J Intern Med 234:115–118
Jawad SH, Askari A, Ward AB (1997) Case history of a patient with multiple sclerosis and scleroderma. Br J Rheumatol 36:502–509
Spadaro A, Sensi F, Barrela M, Francia A (1999) Systemic sclerosis and multiple sclerosis. J Neurol 246(6):497–499
Chroni E, Paschalis C, Stergiou T, Vlahanastasi C, Andonopoulos AP (2002) Multiple sclerosis in the course of systemic sclerosis. Ann Rheum Dis 61(2):188–190
Gorodkin R, Leahy B, Neary D, Herrick AL (2004) Coexistence of systemic sclerosis and multiple sclerosis. J Neurol 251(12):1524–1525
Poser CM, Paty DW, Scheinberg L, Mc Donald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13(3):227–231
Rodriguez-Reyna TS, Alarcon-Segovia D (2005) Overlap syndromes in the context of shared autoimmunity. Autoimmunity 38(3):219–223
Seyfert S, Klapps P, Meisel C, Fischer T, Jungham U (1990) Multiple sclerosis and other immunologic diseases. Acta Neurol Scand 81:37–42
Theodoridou A, Settas L (2006) Demyelination in rheumatic diseases. J Neurol Neurosurg Psychiatry 77(3):290–295
Ram M, Sherer Y, Shoenfeld Y (2006) Matrix metalloproteinase-9 and autoimmune diseases. J Clin Immunol [Epub ahead of print]
Sakkas LI (2005) New developments in the pathogenesis of systemic sclerosis. Autoimmunity 38(2):113–116
Do HT, Baars W, Borns K, Windhagen A, Schwinzer R (2006) The 77C > G mutation in the human CD45 (PTPRC) gene leads to increased intensity of TCR signaling in T cell lines from healthy individuals and patients with multiple sclerosis. J Immunol 176(2):931–938
Johnson NA, Meyer CM, Pingel JT, Thomas ML (1989) Sequence conservation in potential regulatory regions of the mouse and human leukocyte common antigen gene. J Biol Chem 264:6220–6229
Trowbridge IS, Thomas ML (1994) CD45: an emerging role as a protein tyrosine phosphatase required for lymphocyte activation and development. Annu Rev Immunol 12:85–116
Schwinzer R, Witte T, Hundrieser J, Ehlers S, Momot T, Hunzelmann N, Krieg T, Schmidt RE, Wonigeit K (2003) Enhanced frequency of a PTPRC (CD45) exon A mutation (77C→G) in systemic sclerosis. Genes Immun 4(2):168–169
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Pelidou, SH., Tsifetaki, N., Giannopoulos, S. et al. Multiple sclerosis associated with systemic sclerosis. Rheumatol Int 27, 771–773 (2007). https://doi.org/10.1007/s00296-006-0282-5
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DOI: https://doi.org/10.1007/s00296-006-0282-5