Scleroderma Medical News: April 2008

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April 2008

Gastrointestinal manifestations of systemic sclerosis. Systemic sclerosis is a chronic disorder of connective tissue that affects the gastrointestinal tract in more than 80% of patients. Domsic R. (PubMed) Dig Dis Sci. 2008 May;53(5):1163-74. (Also see: GI Involvement )

Small Intestinal Bacterial Overgrowth(SIBO) in Patients Suffering From Scleroderma(SSc) : Clinical Effectiveness of Its Eradication. SIBO occurs more frequently in SSc patients than in controls. Orocecal transit time is significantly delayed in SSc patients, suggesting an impairment of intestinal motility, a further risk factor for the development of SIBO. (Blackwell Synergy) Am J Gastroenterol 2008;103:1–6. (Also see: Bowel Involvement )

Long-term Methotrexate(MTX) for Crohn's Disease(CD): Safety and Efficacy in Clinical Practice. MTX is well tolerated in most CD patients. Although a great proportion of steroid-dependent CD patients achieve disease remission and steroid withdrawal, there is a trend to a loss of efficacy with time. Domenech, Eugeni MD, PhD. Journal of Clinical Gastroenterology. 42(4):395-399, April 2008 (Also see: Crohn's Disease )

Our new page, Oxygen Therapy, covers topics such as Dangers of Oxygen and Flame, Oxygen Carrying Cases, and OxyView glasses! Posted 04/23/08.

Our new page, Diagnosis of Scleroderma Pulmonary Involvement, covers topics such as tests for pulmonary involvement, and diagnosis of pulmonary fibrosis and pulmonary hypertension. Posted 04/25/08.

Patients with Scleroderma (SSc) May Have Increased Risk of Osteoporosis. A Comparison to Rheumatoid Arthritis and Noninflammatory Musculoskeletal Conditions. Increasing the awareness to order bone mineral density measurements in patients with SSc may be warranted based on our results, especially for older patients. Sai Yan Yuen. J Rheumatol. April 15 2008. (Also see: Osteoporosis )

The relationship of dyspnoea to function and quality of life (QoL) in systemic sclerosis (SSc). Interstitial lung disease contributes significantly to the sense of dyspnoea, function and health realted QoL in SSc. Pulmonary hypertension, assessed echocardiographically by the pulmonary artery systolic pressure, predicts the degree of dyspnoea but not function and HRQoL in SSc. M. Baron. Annals of the Rheumatic Diseases 2008;67:644-650. (Also see: Pulmonary Involvement, Fibrosis, and Hypertension )

T cell polarization identifies distinct clinical phenotypes in scleroderma lung disease. Lung involvement is the leading cause of morbidity and mortality in systemic sclerosis. Measurement of T cell polarization may represent a valuable tool to monitor disease activity and predict clinical outcomes in SSc patients with lung disease. Francesco Boin. Arthristis & Rheumatism. Vol 58, Issue 4, Pp 1165 - 1174. (Also see: Pulmonary Involvement and T-cells )

Scleroderma Webcast on Thursday, April 17, 2008 from 12:00 pm— 1:00 pm Central Time, Patient Power with Andrew Schorr, featuring Dr. Art Theodore, Boston Medical Center. Listen live at www.patientpower.info (Click the PARTICIPATE button to listen) Call in live, or e-mail questions to questions@patientpower.info. Posted 04-14-08.

Oral complaints in progressive systemic sclerosis: two cases report. Aesthetic and facial dysfunction are followed by important oral and facial manifestation of disturbances such as xerostomia, the lack of saliva in the mouth, and its associated complications. (PubMed) Med Oral Patol Oral Cir Bucal. 2008 Feb 1;13(2):E114-8. (Also see: Dental Involvement and Diffuse Scleroderma )

Autologous stem cell transplantation (ASCT) in diffuse scleroderma: impact on hand structure and function. ASCT improved hand scleroderma over 12 months and resolved previously refractory tenosynovitis. ASCT secondarily improved hand function (paid employment, followed by self-care, home care, then by sport/hobbies). (PubMed) Intern Med J. 2008 Mar 11. (Also see: SCT, Joint Contratures, and Sclerodactyly )

Home parenteral nutrition (HPN): an effective and safe long-term therapy for systemic sclerosis-related intestinal failure. HPN can be safely and successfully used long-term in patients with SSc and should be considered for patients unable to maintain their nutritional status because of severe gastrointestinal involvement. (PubMed) Rheumatology (Oxford). 2008 Feb;47(2):176-9. (Also see: GI Involvement )

Elevation of Serum Lymphotactin Levels in Patients with Systemic Sclerosis (SSc). Elevated serum lymphotactin levels correlate with relatively milder manifestations in diffuse SSc (dSSc), especially lower severity of lung involvement, suggesting that lymphotactin may play a role in the development of dSSc. Journal of Rheumatology. March 1, 2008. (Also see: Causes of Scleroderma: Cytokines )

The clinical significance of antinucleolar antibodies (ANoA) . Neither the presence nor subtype of ANoA is specific for systemic sclerosis. Laboratory comments appended to results should reflect this fact. (PubMed) J Clin Pathol. 2008 Mar;61(3):283-6. (Also see: Antibodies )

Familial scleroderma (FS): nature, nurture or both? Familial limited scleroderma has a longer prediagnostic latency than familial diffuse scleroderma. FS is likely under-ascertained. In limited scleroderma, Raynaud's or first symptom onset is possibly more genetically determined. A diagnosis due to second symptom onset is more environmentally determined. (PubMed) Intern Med J. 2008 Apr;38(4):235-42. (Also see: Difficult Diagnosis and Causes of Scleroderma: Genetics and Environmental )