A Case Of Polyautoimmunity With Overlap Syndrome: Anca-Associated Vasculitis, Rheumatoid Arthritis, And Systemic Lupus Erythematosus With Ocular And Pulmonary Involvement

To higlight Autoimmune overlap syndromes which represent a diagnostic and therapeutic challenge due to their heterogeneous clinical presentations and multisystem involvement. Cases of patients fulfilling classification criteria for more than one autoimmune disease—such as RA, SLE, and ANCA-associated vasculitis—are rare but clinically significant. Early recognition and aggressive immunosuppression are essential to prevent irreversible organ damage.

The patient was managed as an outpatient case in a hospital setting with multidisciplinary care between ophthalmologist, rheumatologist and

We present a complex case of a 41-year-old female with a history of autoimmune manifestations, who developed multisystem involvement including vasculitic scleritis as a presenting symptoms,  lung vasculitis, polyarthritis, and peripheral neuropathy. The patient was diagnosed with an overlap syndrome of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ANCA-associated vasculitis. She was treated with corticosteroids, methotrexate, azathioprine, and rituximab with partial improvement. Despite remission in pulmonary and ocular symptoms, enthesitis remained a challenge requiring escalation of therapy. This case highlights the diagnostic and therapeutic complexities in managing overlap syndromes with ocular and systemic vasculitis.