Dermatomyositis and polymyositis associated with the antiphospholipid syndrome - A novel overlap syndrome

Objective: As APS (antiphospholipid syndrome) can be either primary or secondary to a wide range of other conditions (such as autoimmune diseases, malignancies, infectious diseases, and drug-induced conditions) the aim of this study was to describe a novel overlap syndrome of APS. Methods: All patients diagnosed with either PM (polymytosis) or DM (dermatomytosis) who were treated in the Rheumatology Unit, Sheba Medical Center, were followed-up in the past 8 years for the appearance of a clinical manifestation of the APS, and conversely, patients with APS treated by us were clinically assessed for the presence of signs and symptoms or PM and DM. Both conditions were diagnosed according to accepted diagnostic criteria. Results: Three patients were found to have both APS and PM/DM. A patient with PM had transverse myelopathy, a patient with DM had pulmonary embolism, and a patient with PM had recurrent abortions, stroke, livedo reticularis and mitral regurgitation. Both patients with PM had also SLE (systemic lupus erythematosis). Conclusions: APS can be associated with a wide range of diseases. Future data would reveal which therapy is the best for the association of PM/DM with APS, and determine the pathogenesis and prognosis in patients with this association.