Assessment of calcinosis in Portuguese patients with systemic sclerosis - a multicenter study

被引：2

作者：

Samoes, Beatriz ^{[1
]}

da Fonseca, Diogo Guimaraes ^{[1
]}

Beirao, Tiago ^{[1
]}

Costa, Flavio ^{[1
]}

Vieira, Romana ^{[1
]}

Terroso, Georgina ^{[2
]}

Ferreira, Raquel Miriam ^{[2
]}

Nicolau, Rafaela ^{[3
]}

Saraiva, Andre ^{[4
]}

Salvador, Maria Joao ^{[4
]}

Duarte, Ana Catarina ^{[5
]}

Cordeiro, Ana ^{[5
]}

Vilas-Boas, Joao Paulo ^{[6
]}

Genrinho, Ines ^{[3
]}

da Silva, Ana Bento ^{[7
,8
]}

Gago, Laura ^{[7
,8
]}

Resende, Catarina ^{[9
]}

Martins, Patricia ^{[9
,10
]}

Madeira, Nathalie ^{[11
]}

Dinis, Sara ^{[11
]}

Couto, Maura ^{[3
]}

Santos, Ines ^{[3
]}

Araujo, Filipe ^{[12
]}

Mourao, Ana Filipa ^{[7
,8
]}

Guerra, Miguel Gomes ^{[13
]}

Oliveira, Margarida ^{[13
]}

Daniel, Alexandra ^{[14
]}

Rodrigues, Marilia ^{[14
]}

Soares, Catarina Dantas ^{[15
]}

Parente, Hugo ^{[15
]}

Furtado, Carolina ^{[16
]}

Fontes, Tomas ^{[16
]}

Abelha-Aleixo, Joana ^{[1
]}

机构：

[1] Ctr Hosp Vila Nova Gaia & Espinho, Rheumatol Dept, Vila Nova De Gaia, Portugal

[2] Ctr Hosp Univ Sao Joao, Rheumatol Dept, Porto, Portugal

[3] Ctr Hosp Tondela Viseu, Rheumatol Dept, Viseu, Portugal

[4] Ctr Hosp & Univ Coimbra, Rheumatol Dept, Coimbra, Portugal

[5] Hosp Garcia de Orta, Rheumatol Dept, Almada, Portugal

[6] Ctr Hosp Baixo Vouga, Rheumatol Dept, Aveiro, Portugal

[7] Ctr Hosp Lisboa Ocidental, Hosp Egas Moniz, Rheumatol Dept, Lisbon, Portugal

[8] NOVA Med Sch, Comprehens Hlth Res Ctr CHRC, Lisbon, Portugal

[9] Ctr Hosp & Univ Lisboa Norte, Ctr Acad Med Lisboa, Rheumatol Dept, Lisbon, Portugal

[10] Ctr Acad Med Lisboa, Inst Med Mol, Unidade Invest Reumatol, Lisbon, Portugal

[11] Hosp Sousa Martins, Rheumatol Dept, Unidade Local Saude Guarda, Guarda, Portugal

[12] SCML, Hosp St Ana, Rheumatol & Osteoporosis Unit, Cascais, Portugal

[13] Ctr Hosp Univ Cova Beira, Rheumatol Dept, Covilha, Portugal

[14] Hosp Dist Leiria, Rheumatol Dept, Leiria, Portugal

[15] Unidade Local Saude Alto Minho, Rheumatol Dept, Ponte do Lima, Portugal

[16] Hosp Divino Espirito Santo, Rheumatol Dept, Ponta Delgada, Portugal

来源：

CLINICAL RHEUMATOLOGY | 2023年 / 42卷 / 08期

关键词：

Calcinosis; Radiography; Subclinical; Systemic sclerosis;

D O I：

10.1007/s10067-023-06617-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction/objectives The study aims to define the clinical and subclinical calcinosis prevalence, the sensitivity of radiographed site and clinical method for its diagnosis, and the phenotype of Portuguese systemic sclerosis (SSc) patients with calcinosis.Method A cross-sectional multicenter study was conducted with SSc patients fulfilling Leroy/Medsger 2001 or ACR/ EULAR 2013 classification criteria, registered in the Reuma.pt. Calcinosis was assessed through clinical examination and radiographs of hands, elbows, knees, and feet. Independent parametric or non-parametric tests, multivariate logistic regression, and sensitivity calculation of radiographed site and clinical method for calcinosis detection were performed.Results We included 226 patients. Clinical calcinosis was described in 63 (28.1%) and radiological calcinosis in 91 (40.3%) patients, of which 37 (40.7%) were subclinical. The most sensitive location to detect calcinosis was the hand (74.7%). Sensitivity of the clinical method was 58.2%. Calcinosis patients were more often female (p = 0.008) and older (p < 0.001) and had more frequently longer disease duration (p < 0.001), limited SSc (p = 0.017), telangiectasia (p = 0.039), digital ulcers (p = 0.001), esophageal (p < 0.001) and intestinal (p = 0.003) involvements, osteoporosis (p = 0.028), and late capillaroscopic pattern (p < 0.001). In multivariate analysis, digital ulcers (OR 2.63, 95% CI 1.02-6.78, p = 0.045) predicted overall calcinosis, esophageal involvement (OR 3.52, 95% CI 1.28-9.67, p = 0.015) and osteoporosis (OR 4.1, 95% CI 1.2-14.2, p = 0.027) predicted hand calcinosis, and late capillaroscopic pattern (OR 7.6, 95% CI 1.7-34.9, p = 0.009) predicted knee calcinosis. Anti-nuclear antibody positivity was associated with less knee calcinosis (OR 0.021, 95% CI 0.001-0477, p = 0.015).Conclusions Subclinical calcinosis high prevalence suggests that calcinosis is underdiagnosed and radiographic screening might be relevant. Multifactorial pathogenesis may explain calcinosis predictors' variability.

引用

页码：2125 / 2134

页数：10

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