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lüll A dermatomyositis and scleroderma overlap syndrome with a remarkable high titer of anti-exosome antibodies Gutierrez-Ramos R; Gonz Lez-Diaz V; Pacheco-Tovar MG; Lopez-Luna A; Avalos-Diaz E; Herrera-Esparza RReumatismo 2008[Oct]; 60 (4): 296-300An overlap syndrome of dermatomyositis and scleroderma is reported. The case corresponded to a 27-year-old female with a clinical picture of 14 months evolution, characterized by proximal muscles weakness, erythematous rash in wrists, knees, ankles, Gottron sign, heliotrope periorbital rash and dysphagia. A muscle biopsy was compatible with dermatomyositis; meanwhile the skin biopsy was compatible with scleroderma. Muscle enzymes were increased. Interestingly, the antinuclear antibody determination in HEp-2 cells was positive with a remarkable titer of 81,920 exhibiting a nucleolar pattern. Anti-Jo1 antibody was negative, but anti-PM/Scl-100 positive. The patient received methylprednisolone and cyclophosphamide pulses, with gradual improvement. Present report constitutes a case of overlap dermatomyositis-scleroderma syndrome, with anti-PM/Scl autoantibodies (anti-exosome). The remarkable of this case was the exceptional high antinucleolar antibody titer.|Adult[MESH]|Autoantibodies/*blood[MESH]|Dermatomyositis/*blood/immunology[MESH]|Exosomes/*immunology[MESH]|Female[MESH]|Humans[MESH]|Scleroderma, Systemic/*blood/immunology[MESH]|Syndrome[MESH] |