General Internal Medicine

Systemic sclerosis

Questions discussed in this category

How do you approach the significance of +RNP III antibody in a patient with positive ANA but no other signs or symptoms of systemic sclerosis?

No history of malignancy. No Raynauds.

1 Answer available

In patients with diffuse scleroderma and symptomatic lower extremity venous insufficiency, would you recommend treatment with endovenous laser/ablation?

The patient has tried conservative measures with compression stockings.

1 Answer available

What would be your recommendation for treatment of worsening lung disease in a patient with long-standing scleroderma after long-term mycophenolate therapy which is no longer an option due to side effect/intolerance?

3 Answers available

How would you approach a patient with anti-scl70 ab positive sine scleroderma complicated by ILD who also has seropositive RA with active arthritis?

Arthritis did not respond to HCQ.

2 Answers available

How would you approach management of a patient with rapidly progressive systemic sclerosis with worsening skin disease, myositis, arthritis, dysphagia and failure to thrive developing within 6 months?

The patient is a young African American female of reproductive age with positive Fibrillarin antibody and nucleolar antibody. No ILD.

1 Answer available

How would you manage a patient with diffuse Systemic Sclerosis who develops severe rapidly progressive calcinosis?

1 Answer available

What is the approach to use of ACE inhibitors for suspected scleroderma renal crisis in patients with only mildly elevated BP and renal artery stenosis?

2 Answers available

Is there a role for systemic therapy for a patient with scleroderma sine sclerosis, with esophageal strictures and Raynaud’s syndrome, but no pulmonary involvement?

1 Answer available

In a patient with history of scleroderma renal crisis resulting in ESRD, would you recommend using steroids for when needed?

1 Answer available

How common are nasal telangiectasia in patients with systemic sclerosis?

Patient with pulmonary hypertension (mixed group 1, 2, 3), COPD, HFpEF, Raynaud’s phenomenon, UCTD (ANA, PM-Scl, SSA-52kd), and recurrent severe...

1 Answer available

How do you manage severe Raynaud's phenomenon with ulceration in scleroderma patients that is refractory to oral agents (CCBs, PDEis, ARBs, and ERAs)?

2 Answers available

Is there any role of sympathectomy in Raynaud’s disease?

2 Answers available

When is the index of suspicion high for paraneoplastic systemic sclerosis in terms of clinical and serological presentation and how will you work it up?

Does it mirror the same approach as SSc without malignancy? Do patients with paraneoplastic SSc present atypically (without usual serologies or featur...

1 Answer available

How do you mitigate the risk of renal crisis from corticosteroids in a patient with UCTD?

1 Answer available

Does calcinosis appear differently in patients with dermatomyositis compared to systemic sclerosis?

1 Answer available

How do you approach the use of steroids for active muscle disease in patients with scleroderma-myositis overlap syndromes?

1 Answer available

Are there scenarios where you send additional antibodies beyond anti-centromere, Scl-70, and RNA polymerase III in suspected scleroderma patients?

1 Answer available

Papers discussed in this category

Semin Arthritis Rheum,

Autoantibodies in systemic sclerosis.

Annals of the rheumatic diseases, 2018-08

Autoantibodies and scleroderma phenotype define subgroups at high-risk and low-risk for cancer.

J Scleroderma Relat Disord, 2020 Mar 17

Advances at the Interface of Cancer and Systemic Sclerosis.

Cureus, 2015 Jun 16

Hereditary Hemorrhagic Telangiectasia with Unusual Associations.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2005 May

Late recurrence of scleroderma renal crisis in a renal transplant recipient despite angiotensin II blockade.

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