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Anti-PM/Scl overlap disease — SCE Rheumatology MCQ

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HardMusculoskeletal investigationsAnti-PM/Scl overlap diseaseSCE Rheumatology

A 39-year-old woman has Raynaud's, puffy fingers and inflammatory myopathy. ANA is positive, anti-PM/Scl antibody is positive, CK is 1,200 IU/L and HRCT shows NSIP-pattern interstitial lung disease. What is the most likely clinical overlap?

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Correct answer: E — Scleromyositis overlap syndrome

Anti-PM/Scl antibody is associated with systemic sclerosis–myositis overlap, often with ILD. The combination of Raynaud's, puffy fingers, myositis and NSIP is not explained by fibromyalgia or isolated RA. Antibody interpretation is useful when anchored to clinical phenotype.

Reference: BSR systemic sclerosis guideline 2024; BSR myositis guideline 2022