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Management of systemic lupus erythemathous with polymyositis overlap syndrome



Abstract

Peningkatan kasus SLE terjadi pada anak di Rumah Sakit Umum Sanglah, pada kasus yang jarang SLE bukan sebagai satu kesatuan namun tumpang tindih dengan penyakit jaringan ikat lainnya. Polymyositis adalah penyakit dengan gejala utama kelemahan otot yang berhubungan dengan nyeri otot. Polymyositis sangat jarang menjadi sindrom yang tumpang tindih dengan SLE, namun terjadi pada 4-6% pasien SLE. Tujuan dari penelitian ini adalah untuk menggambarkan manajemen dan temuan klinis pada SLE dan Polymyositis. Kasus ini seorang perempuan berusia 12 tahun yang mengalami artralgia dan mialgia selama 1 bulan, disertai demam selama 1 bulan, penurunan nafsu makan, ruam pada wajah, fotosensitifitas, mati rasa, kelemahan otot dan kesemutan pada kaki kanan. Diagnosis SLE dibuat berdasarkan kriteria diagnostik American College of Rheumatology. Pemeriksaan neurologis dan elektromiografi signifikan menunjukkan penurunan kekuatan motorik pada tungkai kanan bawah, atrofi gastrocnemius, steppage gait, dan penurunan sensasi sensorik pada dermatom L4-S1 kanan. Oleh karena itu dapat disimpulkan kasus ini adalah kasus sindrom SLE overlap dengan polymyositis. Pasien diobati dengan prednison 2 mg/kg/hari selama 2 minggu, dan juga diberikan ibuprofen 10 mg/kg/dosis untuk menghilangkan rasa sakit, dilanjutkan dengan pemberian azathioprin yang direncanakan selama satu tahun. Pasien menunjukkan hasil yang baik dengan hilangnya gejala dan pemeriksaan laboratorium normal. Kesimpulan dari penelitian ini adalah sindrom SLE overlap dengan polymyositis yang diobati dengan prednison dan ibuprofen dilanjutkan dengan azathioprin menunjukkan hasil yang baik dengan hilangnya gejala serta hasil pemeriksaan laboratorium yang normal.


There has 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 disease. Polymyositis is a disease with a main 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 right foot. Diagnosis of SLE was based on the diagnostic criteria of the American College of Rheumatology. Neurologic examination and electromyography 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, continued with azathioprin plan for one year. Patient showed good result with disappearance of symptomp and normal laboratory examination. The conclusion of the study is SLE overlap syndrome with polymyositis treated with prednison and ibuprofen continue with azathioprin showed good outcome with disappearance of symptomp and normal laboratory examination.

Keywords: Systemic Lupus Erythematous polymyositis children overlap syndrome

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How to Cite

Gading, S., Wati, K. D. K., Witarini, K. A., Santoso, H., & Suwarba, I. G. N. (2019). Management of systemic lupus erythemathous with polymyositis overlap syndrome. Medicina, 50(3). https://doi.org/10.15562/medicina.v50i3.575
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Suryo Gading
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Ketut Dwi Kumara Wati
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Komang Ayu Witarini
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Hendra Santoso
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I Gusti Ngurah Suwarba
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