case_images: PMC9393658_01
case_images: Indirect immunofluorescence image of serum from the patient. The following can be
  observed: nuclear dots in interphase with typical mitoses in a centromere pattern
  (arrows) overlapping with a finely speckled pattern and nucleolar dots with weak
  cytoplasmic fluorescence due to the presence of ATA (asterisks).
case_images: 10.1177_03946320221115310-fig1.jpg
case_images: PMC9393658_01_10.1177_03946320221115310-fig1.jpg
case_images: fig1-03946320221115310
case_images: IIF performed revealed that ACA pattern was overlapping with a nucleolar pattern compatible with ATA (Figure 1).
case_images: Sequential plot of the clinical and immunological results, the functional lung tests
  and the treatment of the patient. ANA; antinuclear antibodies, ACA; anti-centromere
  antibodies, ATA; anti-topoisomerase I antibodies, HRCT; high-resolution computed
  tomography, LcSSc: limited cutaneous systemic sclerosis, FVC; forced vital capacity,
  DLCO; diffusing capacity of the lungs for carbon monoxide.
case_images: 10.1177_03946320221115310-fig2.jpg
case_images: PMC9393658_01_10.1177_03946320221115310-fig2.jpg
case_images: fig2-03946320221115310
case_images: Figure 2 shows the sequential plot.
case_images: Graph of the lung function parameters. FVC: forced vital capacity, DLCO: diffusing
  capacity of the lungs for carbon monoxide.
case_images: 10.1177_03946320221115310-fig3.jpg
case_images: PMC9393658_01_10.1177_03946320221115310-fig3.jpg
case_images: fig3-03946320221115310
case_images: February 2022, the patient had dyspnoea mMRC 2 (lung function tests: FVC 79%, FEV1 78%, DLCO 48% and KCO 77%), persistent cyanosis without digital ulcers and no synovitis. Figure 3 shows a graph of the lung function parameters.