What do I mean by Lupus overlap diseases?
Many people with Lupus have symptoms of one or more of other connective tissue diseases. Your doctor may refer to this as an “overlap.”
These overlap diseases are usually a closely related group of disorders that affect the connective tissues of the body.
I have actually been diagnosed with a few of these overlaps as well. To date, I have been diagnosed with Sjogren’s Syndrome, Scleroderma (CREST), Polymyositis, and Dermatomyositis, Raynaud’s Syndrome, and Vitiligo as well as SLE. My doctor also is suspecting the presence of Sarcoidosis in my body but she stopped short of a diagnosis.
Systemic Sclerosis, also known as Scleroderma, is an autoimmune disease derived from the Greek words “sclero”meaning hard and “derma” meaning skin. One of the most common symptoms of this condition is the hardening of the skin.
The milder form of Scleroderma is called localized Scleroderma. This localized version of the disease is generally found to affect the skin and muscles only. It does not attack internal organs much like Lupus and other autoimmune diseases.
The more complicated form of Scleroderma, which I have, is called Systemic Scleroderma. This type can attack different internal organs along with the skin including the esophagus, gastrointestinal tract, lungs, kidneys, and heart. It can also affect the muscles, joints, and blood vessels. The hardening of these organs and tissues can cause them to function less efficiently.
Rheumatoid arthritis is another autoimmune disease that attacks healthy tissues. As a result of the attack, fluid builds up in a patient’s joints, causing pain in the joints and inflammation that is systemic, meaning it can occur throughout the body. A patient will likely experience various periods of flares and remissions that differ in length and severity.
Raynaud’s Phenomenon represents a problem with blood flow that causes your fingers, toes, and the tip of your nose and ears to feel numb and cool in response to cold temperatures or stress. It can be quite an annoyance and affect your day unexpectedly. Most of the time it only lasts for a short period while your body is reacting to the cold or stress. In Raynaud’s disease, the smaller arteries that supply blood to your skin narrow and limit blood circulation to affected areas. Like many of the diseases listed as “overlap” diseases, women are more likely to have Raynaud’s disease. Go figure.
Sjogren’s syndrome is characterized by inflammation of the exocrine glands. The symptoms vary from person to person. In my case, it affects my eyes and mouth mostly. My eyes and mouth get extremely dry and I have been put on Pilocarpine. It has shown to be quite helpful with my Sjogren’s. The Pilocarpine eye drops add moisture and the Pilocarpine pills taken orally assist my mouth in creating saliva.
Some people with Sjogren’s may experience digestive disorders which should be thoroughly discussed with your doctor to provide the best remedy. Pancreatic enzymes are often added to a person’s diet to help alleviate digestive problems.
Like other autoimmune diseases, the complications of Sjogren’s are much broader than the digestive system, eyes, and mouth. Do not hesitate to speak with your doctor concerning any new symptoms that are unrelated to your mouth and eyes. It is important to address new symptoms that may arise to avoid greater severity.
POLYMYOSITIS / DERMATOMYOSITIS
Polymyositis and dermatomyositis are disorders of the body’s connective tissues, which include tendons, ligaments and the dense sheets of collagen-based tissue that cover the ends of the muscles.
These diseases cause swelling and tenderness in the muscles (polymyositis) and sometimes the skin (dermatomyositis). The disease causes weaknesses in the arms and legs.
Both Polymyositis and dermatomyositis have symptoms in common with sclerosis or sometimes lupus.
Signs of these conditions may appear suddenly and severely or gradually and more mildly. Symptoms are more likely to be gradual in older people. Sometimes a person may have a serious infection before the symptoms begin.
The symptoms include:
- Muscle weakness. This is usually not noticeable until the disease is advanced and about half the muscle fibers have been destroyed. A person may have difficulty raising his or her arms above the shoulders, climbing steps or rising from sitting. If the neck muscles are seriously affected, it may not be possible for the person to lift his or her head from the pillow. If the muscles of the throat are affected, the person may have difficult using his or her voice.
- Contraction of the arms and legs. While the hands, feet and face are usually not affected by this condition, the arms and legs may tighten up in the late stages of the disease.
- Shortness of breath. This is caused by gradual damage and weakness of the chest wall and the muscles that move the diaphragm during breathing.
- Difficulty swallowing. This may occur when the muscles of the throat and esophagus (the tube that connects the mouth to the stomach) are involved
- Muscle tenderness or pain
- Raynaud’s phenomenon
- Feeling tired
- Weight loss
Compared to lupus or sclerosis, there is relatively little organ involvement with polymyositis. Sometimes, however, the effect on specific organs may be the first symptoms. These include breathing problems, heart disorders involving irregular rhythms or electrical signals, kidney failure or digestive tract ulcers.
If dermatomyositis occurs along with polymyositis, symptoms may also include:
- Skin rash. This can be either raised and smooth or scaly. It may appear on the forehead, the neck, shoulders, chest and back, forearms and lower legs, elbows and knees or the joints of the fingers, toes, wrists and ankles.
- Swelling around the eye. This may look purplish and bruised.
- Swelling at the base and sides of the fingernails
- Splitting of the skin of the fingers
While the skin eruptions often completely fade away, some leave behind brownish spots, scars or smooth white patches.
As you can see, most of the disorders listed above occur or “overlap” in other autoimmune diseases and may be difficult to differentiate which ones are originating from what. Therefore it is important to keep open communication with your doctor regarding your symptoms. If you don’t feel comfortable speaking with your doctor or your doctor dismisses your concerns, it may be time to try to build a new relationship with a new doctor.
Be vigilant and stay informed. If you have questions, be sure to keep a list of them and ask your doctor at your next appointment. Whatever it takes, make your doctor pay attention to your concerns. Your doctor is your first line of defense in your fight. Good luck.
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