{
  "abstract": "Introduction Systemic sclerosis(SSc) and systemic lupus erythematosus(SLE) are distinct connective tissue diseases, yet overlap syndromes are recognized. Patients fulfilling criteria for both represent a rare subgroup with heterogeneous manifestations and potentially severe organ involvement. Kidney disease may present as scleroderma renal crisis(SRC) or lupus-nephritis(LN), but data on frequency, characteristics and outcomes in SSc-SLE overlap remain scarce.Material and Methods Objectives– To describe the clinical characteristics SSc-SLE overlap.– To compare demographic, clinical, and immunological features between patients with biopsy-proven LN and those without renal involvement.MethodsA cohort of 415 SSc-patients fulfilling both SSc and SLE criteria were retrospectively analyzed. Demographic, clinical, laboratory, and histopathological data were collected. Patients biopsy-confirmed renal involvement formed the LN subset and were compared with those without LN. Statistical significance was defined as p <0.05.Results Fourteen patients(3.4%) had SSc-SLE overlap, 13 female. Notably, 5/14 also had Sjögren’s-syndrome(SJS). Eight developed glomerulonephritis: 7 LN and 1 primary membranous-nephropathy(PLA2R+). No SRC or thrombotic microangiopathy(TMA) occurred.Median age at onset was 36(14-65)years (SSc) and 35(12-62)years (SLE). SSc preceded SLE in 4/14(28%), was simultaneous in 3/14(21.4%), and followed SLE in 7/14(50%).Anti-U1RNP was most frequent(64.2%), followed by ACA(28.5%); RNApol-III was absent, and 50% lacked SSc-specific autoantibodies. Most had limited cutaneous SSc (57.1%) and 42.9% had digital ulcers. Raynaud’s phenomenon was the first SSc manifestation in all; NFC showed active, late, and early Cutolo’s-patterns in 50%, 28.5% and 21.4%,respectively. Interstitial lung disease (NSIP-pattern) occurred in 5/14, esophageal involvement in 8/14, and PAH in 2/14.SLE onset was most often cutaneous(42.8%), followed by arthritis(35.7%) and LN (21.4%). Anti-dsDNA positivity was 64.3%; C1q was positive in one patient(PLA2R+.PMN). All patients with arthritis(85.7%) were RF-positive.Several clinical, vascular and serological findings showed significant correlations, as summarized in table 1.No other features were associated with LN, and renal outcomes were comparable between groups.Patients with worse renal function during LN were more often treated with biologic therapies. Interestingly, biologic use was also associated with better renal outcome.Conclusions SSc–SLE overlap is rare(~3%). Half of the patients developed LN; however, renal outcomes did not differ between groups, and no cases of SRC or TMA occurred. Anti-RNP positivity and arthritis were linked to earlier SLE onset. Additional associations emerged between vascular, serological, and inflammatory features. Biologic therapy correlated with better renal outcomes.This study provides a detailed characterization of SSc–SLE overlap, highlighting patterns that may aid early recognition and management. Validation in larger cohorts is needed.Abstract P.349 Table 1Significant associations in the SSc-SLE overlap cohort",
  "authors": [
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Helena Codes Méndez"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Jose Luis Tandaipan"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Guillem Verdaguer"
    },
    {
      "affiliations": [
        "Fundació Puigvert - Department of Nephrology, Barcelona, Spain"
      ],
      "name": "Montse Diaz"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Helena Marco"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Anna Dominguez"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Berta Magallares"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Patricia Moya"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Cesar Diaz-Torné"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Hye-Sang Park,"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Luis Sainz"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Julia Bernardez"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Ana Laiz"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Hector Corominas"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau - Department of Rheumatology,, Barcelona, Spain"
      ],
      "name": "Ivan Castellvi"
    }
  ],
  "title": "P.349 Systemic sclerosis–systemic lupus erythematosus overlap: a rare subgroup with distinct renal and clinical features",
  "uid": "3d305551-f7d1-527a-8d16-f076904625d8"
}