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Multiple sclerosis in the course of systemic sclerosis
  1. E Chroni1,
  2. C Paschalis1,
  3. T Stergiou1,
  4. C Vlahanastasi2,
  5. A P Andonopoulos2
  1. 1Department of Neurology, University of Patras, Patras, Greece
  2. 2Division of Rheumatology, Department of Medicine, University of Patras
  1. Correspondence to:
    Professor A P Andonopoulos, Division of Rheumatology, Department of Medicine, University of Patras School of Medicine, 265 00 Rio, Patras, Greece;

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We describe the case of a young woman with longstanding systemic sclerosis (SSc), who later developed multiple sclerosis (MS), and discuss the possible explanations for this rare co-occurrence.

A 30 year old white woman was admitted to the department of neurology of our institution with 10 days' history of vertigo and diplopia. A year earlier the patient had had an episode of paraesthesiae of her right leg, which resolved spontaneously within two to three weeks. Since the age of 22, she had been under the care of the rheumatology service of the same hospital for SSc, and her condition remained stable with treatment with d-penicillamine 500 mg daily and methylprednisolone 2 mg daily.

Clinical examination showed an alert woman with normal vital signs and typical appearance of scleroderma—that is, tightness and atrophy of the skin of her face and hands with contractions of her fingers. Examination of the lungs, heart, and abdomen showed no abnormality. Fundoscopy disclosed temporal pallor bilaterally. There was vertical nystagmus on …

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