Overlap of systemic sclerosis and lupus erythematosus in a patient with an incidental finding of congenital heart disease

• Autores: López-García, Martha Ivonne, Arreguín-Reyes, Roberto, García-Galicia, Arturo, Contreras-Sánchez, Zaira Aketzali, Barrera-Hernández, Susana, Montiel-Jarquín, Álvaro José
• Formato: artículo
• Fecha de Publicación: 2026
• Institución: Universidad de San Martín de Porres
• Repositorio: Horizonte médico
• Lenguaje: español
• OAI Identifier: oai:horizontemedico.usmp.edu.pe:article/4243
• Enlace del recurso: https://horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/4243
• Nivel de acceso: acceso abierto
• Materia: Scleroderma, Systemic; Lupus Erythematosus, Systemic; Heart Defects, Congenital; Autoinmune Diseases; Connective Tissue Diseases; Esclerodermia Sistémica; Lupus Eritematoso Sistémico; Cardiopatías Congénitas; Enfermedades Autoinmunes; Enfermedades del Tejido Conjuntivo

Systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) are complex autoimmune diseasescharacterized by multisystem involvement. The coexistence of both diseases may complicate diagnosis and treatment and may be associated with cardiovascular and renal involvement, posing challenges for the individualized management of congenital heart disease. Both diseases may present with particular cardiac manifestations, especially conduction abnormalities and pericardial damage. The presence of an atrial septal defect (ASD) may further complicate therapeutic and cardiovascular management.We present the case of a 26-year-old woman with overlap of SSc and SLE, whose initial symptom was Raynaud’s phenomenon, characterized by intermittent vasoconstriction of the microvasculature in response to cold or stress. Immunologic studies showed antibodies compatible with both diseases, notably anti-dsDNA, anti-Sm, anti-Scl-70, and anti-Ku. She was referred because of renal abnormalities with suspicion of lupus nephritis, a complication affecting up to 60 % of patients with SLE. During hospitalization, she developed a pericardial effusion related to lupus activity and showed clinical improvement after receiving immunomodulatory and immunosuppressive therapy. In addition, the echocardiogram incidentally revealed an ASD, a common congenital heart defect in adults, unrelated to autoimmune diseases, but which prolonged her hospital stay. This case highlights the diagnostic andtherapeutic complexity of overlap syndromes and the importance of a comprehensive approach in patients with multiorgan involvement.