Journal List > J Rheum Dis > v.20(4) > 1064055

Jang, Kim, Hong, Lee, Ran-Song, Yang, and Lee: A Case of Overlap Syndrome of Rheumatoid Arthritis and Polymyositis with the Involvement of Upper Pharyngeal Muscles

Abstract

An overlap syndrome is a combination of major features of more than one connective tissue diseases which is presented in the same patient. An overlap syndrome of rheumatoid arthritis (RA) and polymyositis (PM) which involved the upper pharyngeal muscle has not been reported in Korea. Herein, we report a rare case of a patient with a long-history RA presenting proximal muscle weakness and swallowing difficulty, who was successfully treated with a high-dose of corticosteroid, azathioprine and tacrolimus.

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Figure 1.
Both hand radiographs show characteristic features of rheumatoid arthritis, including periarticular osteopenia, joint space narrowing and articular erosions of carpometacarpal, radiocarpal and intercarpal joints.
jrd-20-251f1.tif
Figure 2.
Radiographic changes typical of rheumatoid arthritis on anteroposterior foot X-ray. This revealed bony erosions with joint space narrowing of both metatarsophalangeal, intertarsal and tarsometatarsal joints.
jrd-20-251f2.tif
Figure 3.
Initial chest radiograph shows characteristic findings of a “tuberculosis-destroyed lung” (A). A chest computed tomography revealed interstitial lung disease at the basal portion of the right lower lobe (B).
jrd-20-251f3.tif
Figure 4.
Videofluoroscopic swallowing study shows barium liquid (5 ml) transfer with mild stasis in the esophageal phase.
jrd-20-251f4.tif
Figure 5.
Clinical course of the patient. Muscle strength was assessed by the physical examination.
jrd-20-251f5.tif
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