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Clinical and autoantibody profile in systemic sclerosis: baseline characteristics from a West Malaysian cohort
Author(s) -
Sujau Ibrahim,
Ng Chin Teck,
Sthaneshwar Pavai,
Sockalingam Sargunan,
Cheah Tien Eang,
Yahya Fariz,
Jasmin Raja
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12322
Subject(s) - medicine , autoantibody , gastroenterology , cohort , scleroderma (fungus) , interstitial lung disease , gerd , telangiectasia , pulmonary function testing , antibody , disease , lung , pathology , reflux , immunology , inoculation
Aim To evaluate the clinical and antibody profile of systemic sclerosis ( SS c) in a Malaysian cohort. Methods Consecutive patients with SS c in U niversity M alaya M edical C entre from M arch to N ovember 2012 were included in this study. In addition to clinical characterization, all subjects underwent autoantibody testing using Euroline immunoblot assay. The association between clinical features and autoantibody profile was evaluated. Results There were 31, predominantly C hinese (45.2%), subjects. Limited cutaneous disease was the most common subtype (71%). Raynaud's phenomenon was the most commonly observed feature (83.9%). Nine (29%) had esophageal dysmotility symptoms and 23 (74.2%), including all patients with diffuse SS c, had symptoms of gastro‐esophageal reflux disease ( GERD ). Restrictive pattern on pulmonary function test and evidence of lung fibrosis were seen in more than 70% of patients. Echocardiographic evidence of pulmonary arterial hypertension was seen in 58.1%. Telangiectasia, calcinosis, digital ulcers, digital pulp loss or pitting were seen more commonly in the diffuse subtype. The two most prevalent autoantibodies were anti‐Scl‐70 and anti‐Ro‐52. The presence of anti‐Scl‐70 was significantly associated with restrictive lung disease ( P = 0.05). Anti‐Ro‐52 was associated with control subjects with other autoimmune diseases ( P = 0.043). The presence of anti‐ PM ‐Scl‐75 was associated with overlap syndrome ( P = 0.032). Patients with anticentromere antibodies were more likely to have vasculitic rash ( P = 0.012). Conclusion In Malaysia, SS c most commonly affects the C hinese. Limited cutaneous is more common than diffuse subtype. Features of CREST (calcinosis, Reynaud disease, esophageal dysmotility, sclerodactyly, telangiectasia) are more commonly observed in the diffuse cutaneous subgroup. A nti‐ S cl‐70 and anti‐ R o‐52 antibodies are promising biomarkers for pulmonary involvement in SS c.