Juvenile overlap syndromes are rare and complex conditions characterized by the coexistence of clinical and immunological features of at least two distinct connective tissue diseases. Although well described in adults, these entities remain exceptional in pediatric populations, particularly in sub-Saharan Africa, where available data are scarce. We report two cases of juvenile overlap syndromes managed in a hospital setting: an 11-year-old girl with systemic lupus erythematosus-systemic sclerosis overlap, and an 8-year-old girl with dermatomyositis-systemic sclerosis overlap. The first case combined inflammatory polyarthritis, cutaneous lupus manifestations, diffuse skin sclerosis with Raynaud phenomenon, and a mixed immunological profile including positive anti-dsDNA and anti-Scl70 antibodies. The second case was characterized by proximal inflammatory myopathy, heliotrope rash, Gottron papules, diffuse skin sclerosis, complicated by early pulmonary fibrosis and pulmonary arterial hypertension. Management was based on tailored immunosuppressive therapy, including corticosteroids and disease-modifying agents (mycophenolate mofetil, hydroxychloroquine), with a favorable clinical outcome in the two cases. These observations highlight the diagnostic and therapeutic challenges of juvenile overlap syndromes in resource-limited settings and emphasize the need for multicenter African studies to better define their clinical, immunological, and prognostic profiles.
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