P47 Condition Overlay And Diagnostic Delay – A Challenging Case Of Fibromyalgia And Systemic Lupus Erythematosus

This case study discusses the diagnostic challenges and therapeutic complexities in a 43-year-old female patient with fibromyalgia and systemic lupus erythematosus (SLE), who experienced a significant diagnostic delay. Initially misdiagnosed with fibromyalgia, the patient later presented with severe neuropsychiatric SLE (NPSLE) symptoms, including aseptic meningitis and ischemic stroke, alongside antiphospholipid syndrome (APS). The case underscores the difficulty in distinguishing between fibromyalgia and SLE symptoms, emphasizing the need for a high index of suspicion for timely diagnosis. Management was complicated by concurrent infections, necessitating a multidisciplinary approach and alternative therapies like intravenous immunoglobulin and plasma exchange, as traditional treatments were contraindicated. The study highlights the importance of Anti-Sm antibodies in diagnosing SLE and the potential for misattribution of symptoms when fibromyalgia is present.