Dr.Jyoti Deswal

Dr. NEEBHA ANAND, DR. PREETAM RAJ KURREY

Abstract

Overlap syndrome is a spectrum of inflammatory conditions with clinical features of two or more classical connective tissue diseases. It includes rheumatoid arthritis, SLE, scleroderma and myositis.A 36 year old female presented to eye OPD with history of acute onset diplopia since 10 days. On examination BCVA was 6/9 (B/E). R/E showed limitation of inferior rectus and medial rectus. Rest of the ocular movements were normal. Patient was a diagnosed case of SLE overlap syndrome since 6 months and on treatment for the same. The overlap syndrome features included SLE with mixed connective tissue disorder (MCTD) with rheumatoid arthritis, Sjogren syndrome and peripheral myopathy (confirmed with specific tests). MRI brain and orbit showed normal study. SLE with or without overlap syndrome should be considered as a differential diagnosis for isolated oculomotor nerve palsy. This can be effectively treated with steroid pulse therapy and immuno modulators.