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Lupus in Overlap and Complications

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Lupus and MCTD
Lupus and Endometriosis
Lupus and Epstein–Barr Virus
Lupus and IBS
Lupus and Myopathy
Lupus and Pancreatitis
Lupus and Scleroderma
Lupus and Sjogren's

Overview of Lupus in Overlap

When lupus appears along with other autoimmune diseases such as scleroderma and Sjögren's, it is often referred to as an overlap syndrome. (Also see Autoimmune Diseases and Overview of Lupus)

Lupus and Overlap Syndromes

Overlap Syndromes. Lupus can occur as just one part of overlap syndromes, including Mixed Connective Tissue Disease (MCTD). ISN.

Overview of Polyautoimmunity
Scleroderma in Overlap
Connective Tissue Disease (CTD)
Mixed Connective Tissue Disease (MCTD)
Multiple Autoimmune Syndrome
Shared Autoimmunity
Undifferentiated Connective Tissue Disease (UCTD)
Overlap Patient and Caregiver Stories

Lupus and Endometriosis

The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis. The observed associations between endometriosis and autoimmune diseases suggest that clinicians need to be aware of the potential coexistence of endometriosis and autoimmune diseases when either is diagnosed. PubMed, Hum Reprod Update, 2019 Jul 1;25(4):486-503.

Lupus and Epstein–Barr Virus

Anti-C1q Antibodies as Occurring in Systemic Lupus Erythematosus (SLE) Could Be Induced by an Epstein-Barr Virus (EBV)-Derived Antigenic Site. These findings suggest that anti-C1q in SLE patients could be induced by an EBV-derived epitope through molecular mimicry. PubMed, Front Immunol, 2019 Nov 7;10:2619.

Proteome-Wide Epstein-BarrVirus (EBV) Analysis of Peptide Sharing with Human Systemic Lupus Erythematosus (SLE) Autoantigens. This study thoroughly describes the EBV vs. SLE autoantigens peptide overlap and powerfully supports cross-reactivity as a major mechanism in EBV-associated SLE etiopathogenesis. PubMed, Isr Med Assoc J, 2019 Jul;21(7):444-448.

Lupus and Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS)-type symptoms in female patients with mild systemic lupus erythematosus (SLE): frequency, related factors and quality of life. IBS-type symptoms are highly prevalent among women with SLE and are associated with fibromyalgia (FM) and depression. SLE+IBS patients had worse quality of life (HRQOL) vs Non-IBS SLE, independently of FM status. Treating IBS symptoms may improve HRQOL in women with SLE. PubMed, Neurogastroenterol Motil. (Also see Fibromyalgia, and Depression)

Lupus and Myopathy

Clinical and laboratory features of overlap syndromes of idiopathic inflammatory myopathies associated with systemic lupus erythematosus (SLE), systemic sclerosis (SSc), or rheumatoid arthritis (RA). The clinical manifestations of dermatomyositis/polymyositis were identified simultaneously with SSc and RA in the majority of cases, in contrast to identification in the SLE group. PubMed, Clin Rheumatol. (Also see Rheumatoid Arthritis in Overlap and Myopathy and Myositis)

Lupus and Pancreatitis

Systemic Lupus Erythematosus-Related Pancreatitis in Children: Severe and Lethal Form. Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease of unknown cause and its occurrence in children is rare, and acute pancreatitis is exceptional in this matter. PubMed, Case Rep Pediatr, 2018 Dec 31;2018:4612754. (Also see Pancreatitis)

Lupus and Scleroderma

Scleroderma is frequently misdiagnosed as lupus in its initial stages. (Also see Autoimmune Diseases, Difficult Diagnosis, What is Scleroderma?, and Overlap Syndrome)

Olfactory function in systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). A longitudinal study and review of the literature. Both SLE and SSc patients with longstanding disease had significant reduction in all stages of the Sniffin' Sticks test (TDI) that maintained stable over a 2–year period. PubMed, Autoimmun Rev, 02/11/2018. (Also see Brain Involvement)

Lupus and Sjogren's Syndrome

When lupus and Sjogren's occur together, it can indicate a milder course for both diseases. Older white females are more vulnerable to this overlap, and they tend to have sun sensitivity, oral ulcers, Raynaud's, and certain antibodies.

Two subgroups in systemic lupus erythematosus (SLE) with features of antiphospholipid (APS) or Sjögren's syndrome (SS) differ in molecular signatures and treatment perspectives. Stratifying SLE patients based on an autoantibody profile could be a way forward to understand underlying pathophysiology and to improve selection of patients for clinical trials of targeted treatments. PubMed, Arthritis Res Ther, 2019 Feb 18;21(1):62. (Also see Sjögren's Syndrome and Antiphospholipid Syndrome)

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