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MODERN RHEUMATOLOGY Vol.14 No.6

>MR14-6

A rare case of systemic sclerosis complicated with multiple autoimmune diseases (Sjogren's syndrome, Graves' disease, and primary biliary cirrhosis)
Noriko Iikuni1 , Midori Hanzawa1, Shuji Ohta1 and Makoto Nishinarita1
(1) Department of Rheumatology, Taga General Hospital, 2-1-2 Kokubun-cho, Hitachi 316-0035, Japan
(2) Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan

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Abstract
We report the case of a 54-year-old woman with systemic sclerosis and Sjogren's syndrome, followed by a simultaneous onset of Graves' disease and primary biliary cirrhosis. Eight years after the patient was diagnosed with systemic sclerosis and secondary Sjogren's syndrome, she complained of thirst and lower extremity muscle weakness. Initially, these symptoms were thought to be due to her original diseases, but laboratory data revealed thyroid dysfunction as well as liver dysfunction, and further tests confirmed the diagnoses of Graves' disease and primary biliary cirrhosis. The patient was treated with thiamazole and ursodeoxycholic acid. Following treatment, her symptoms were relieved, and laboratory data improved. Although a combination of these diseases is rare, it is important to keep in mind that various autoimmune diseases can occur simultaneously, and early detection and therapy are important.
 
Key words
Autoimmune diseases - Graves' disease (GD) - Primary biliary cirrhosis (PBC) - Sjogren's syndrome (SS) - Systemic sclerosis (SSc)
 
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