Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.10/2376 |
Resumo: | OBJECTIVES: The aim was to define clinical characteristics and long-term survival of patients with dcSSc and positive ACA. METHODS: We identified all cases of ACA+ SSc in our cohort (n = 1313). Those with dcSSc (ACA+ diffuse) were compared with representative groups of consecutive ACA+ patients with limited subset (ACA+ limited) and ACA- dcSSc (non-ACA diffuse). RESULTS: Thirty-five patients (2.7%) were ACA+ diffuse. The peak modified Rodnan skin score was not significantly different between the dcSSc subgroups, but it occurred later in the disease course in ACA+ diffuse (88.54 vs 30.65 months, P < 0.001). Patterns of organ involvement were different between the groups. ACA+ diffuse had a higher incidence of interstitial lung disease than ACA+ limited (22.86 vs 4.43%, P = 0.001), but lower than non-ACA diffuse (41.18%, P = 0.042). More patients developed pulmonary hypertension in the ACA+ diffuse group (28.5 vs 12.0% ACA+ limited or 12.0% non-ACA diffuse), although this was attributable to the longer follow-up in these patients. The cumulative incidence of pulmonary hypertension was not different from the other two groups. The incidence of cardiac involvement was similar between the dcSSc groups, and scleroderma renal crisis was more frequent in the non-ACA diffuse group. Survival in ACA+ patients was similar in both subsets, whereas non-ACA diffuse had higher mortality. CONCLUSION: ACA+ dcSSc is uncommon and has a distinct clinical phenotype, with a more insidious onset of skin and organ involvement. Even in dcSSc, ACA appears protective for organ-based complications, namely interstitial lung disease and scleroderma renal crisis, and is associated with a better survival than expected in dcSSc. |
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Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosisSystemic sclerodermaSurvival analysisPrognosisOBJECTIVES: The aim was to define clinical characteristics and long-term survival of patients with dcSSc and positive ACA. METHODS: We identified all cases of ACA+ SSc in our cohort (n = 1313). Those with dcSSc (ACA+ diffuse) were compared with representative groups of consecutive ACA+ patients with limited subset (ACA+ limited) and ACA- dcSSc (non-ACA diffuse). RESULTS: Thirty-five patients (2.7%) were ACA+ diffuse. The peak modified Rodnan skin score was not significantly different between the dcSSc subgroups, but it occurred later in the disease course in ACA+ diffuse (88.54 vs 30.65 months, P < 0.001). Patterns of organ involvement were different between the groups. ACA+ diffuse had a higher incidence of interstitial lung disease than ACA+ limited (22.86 vs 4.43%, P = 0.001), but lower than non-ACA diffuse (41.18%, P = 0.042). More patients developed pulmonary hypertension in the ACA+ diffuse group (28.5 vs 12.0% ACA+ limited or 12.0% non-ACA diffuse), although this was attributable to the longer follow-up in these patients. The cumulative incidence of pulmonary hypertension was not different from the other two groups. The incidence of cardiac involvement was similar between the dcSSc groups, and scleroderma renal crisis was more frequent in the non-ACA diffuse group. Survival in ACA+ patients was similar in both subsets, whereas non-ACA diffuse had higher mortality. CONCLUSION: ACA+ dcSSc is uncommon and has a distinct clinical phenotype, with a more insidious onset of skin and organ involvement. Even in dcSSc, ACA appears protective for organ-based complications, namely interstitial lung disease and scleroderma renal crisis, and is associated with a better survival than expected in dcSSc.Oxford University PressRepositório do Hospital Prof. Doutor Fernando FonsecaCaetano, JNihtyanova, SHarvey, JDenton, COng, V2019-12-23T14:10:28Z2018-01-01T00:00:00Z2018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.10/2376engRheumatol Adv Pract. 2018 Mar 7;2(1):rky002.2514-177510.1093/rap/rky002info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-20T15:53:03Zoai:repositorio.hff.min-saude.pt:10400.10/2376Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:53:19.081938Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
title |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
spellingShingle |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis Caetano, J Systemic scleroderma Survival analysis Prognosis |
title_short |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
title_full |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
title_fullStr |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
title_full_unstemmed |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
title_sort |
Distinctive clinical phenotype of anti-centromere antibody-positive diffuse systemic sclerosis |
author |
Caetano, J |
author_facet |
Caetano, J Nihtyanova, S Harvey, J Denton, C Ong, V |
author_role |
author |
author2 |
Nihtyanova, S Harvey, J Denton, C Ong, V |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Hospital Prof. Doutor Fernando Fonseca |
dc.contributor.author.fl_str_mv |
Caetano, J Nihtyanova, S Harvey, J Denton, C Ong, V |
dc.subject.por.fl_str_mv |
Systemic scleroderma Survival analysis Prognosis |
topic |
Systemic scleroderma Survival analysis Prognosis |
description |
OBJECTIVES: The aim was to define clinical characteristics and long-term survival of patients with dcSSc and positive ACA. METHODS: We identified all cases of ACA+ SSc in our cohort (n = 1313). Those with dcSSc (ACA+ diffuse) were compared with representative groups of consecutive ACA+ patients with limited subset (ACA+ limited) and ACA- dcSSc (non-ACA diffuse). RESULTS: Thirty-five patients (2.7%) were ACA+ diffuse. The peak modified Rodnan skin score was not significantly different between the dcSSc subgroups, but it occurred later in the disease course in ACA+ diffuse (88.54 vs 30.65 months, P < 0.001). Patterns of organ involvement were different between the groups. ACA+ diffuse had a higher incidence of interstitial lung disease than ACA+ limited (22.86 vs 4.43%, P = 0.001), but lower than non-ACA diffuse (41.18%, P = 0.042). More patients developed pulmonary hypertension in the ACA+ diffuse group (28.5 vs 12.0% ACA+ limited or 12.0% non-ACA diffuse), although this was attributable to the longer follow-up in these patients. The cumulative incidence of pulmonary hypertension was not different from the other two groups. The incidence of cardiac involvement was similar between the dcSSc groups, and scleroderma renal crisis was more frequent in the non-ACA diffuse group. Survival in ACA+ patients was similar in both subsets, whereas non-ACA diffuse had higher mortality. CONCLUSION: ACA+ dcSSc is uncommon and has a distinct clinical phenotype, with a more insidious onset of skin and organ involvement. Even in dcSSc, ACA appears protective for organ-based complications, namely interstitial lung disease and scleroderma renal crisis, and is associated with a better survival than expected in dcSSc. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01T00:00:00Z 2018-01-01T00:00:00Z 2019-12-23T14:10:28Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.10/2376 |
url |
http://hdl.handle.net/10400.10/2376 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Rheumatol Adv Pract. 2018 Mar 7;2(1):rky002. 2514-1775 10.1093/rap/rky002 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Oxford University Press |
publisher.none.fl_str_mv |
Oxford University Press |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799130400523550720 |