Most Read Articles
01 Nov 2013

Joint stiffness is defined as discomfort after a period of inactivity. It is associated with reduced or loss of range of motion in a joint.

Stephen Padilla, 25 Nov 2016
The addition of supervised physiotherapy to usual care does not provide clinically important improvement in the management of simple ankle sprains in a general population of patients seeking hospital-based acute care, according to results of a recent randomized controlled trial.
24 Jul 2017
The toxic side-effects of chemotherapy appear to be induced by cell-free chromatin (cfCh) fragments released from dying cells, triggering DNA damage, apoptosis and inflammation in healthy cells, thereby exaggerating or amplifying the toxic effects caused by the drugs themselves, according to a study.

Scleroderma renal crisis uncommon in Asians with systemic sclerosis

01 Sep 2017

Scleroderma renal crisis (SRC) appears to be a rare complication in Thai patients with systemic sclerosis (SSc), but is associated with high mortality, according to a study. Digital gangrene, current prednisolone dose ≥15 mg/day, serum albumin <3 mg/dL and cardiac involvement are independently associated with SRC.

Researchers retrospectively examined the medical records of 608 SSc patients seen at the Division of Rheumatology, Chiang Mai University. Each SRC patient was matched by disease duration (±1 year) with four SSc patients without SRC.

A total of 19 patients developed SRC (63.2 percent with hypertensive renal crisis; 36.8 percent with normotensive renal crisis), yielding an SRC prevalence of 3.13 percent. The mean age was 56.2 years, and median disease duration was 5 months. Majority (89.5 percent) had diffuse cutaneous SSc. There were 15 patients (78.9 percent) who required dialysis and 10 (52.6 percent) who died.

Multivariate conditional logistic regression analysis found SRC to be independently associated with digital gangrene (adjusted odd ratio [AOR], 31.41; 95 percent CI, 1.16 to 852.23; p=0.041), current prednisolone dose ≥15 mg/day (AOR, 31.22; 1.59 to 613.85; p=0.024), serum albumin <3 mg/dL (AOR, 7.97; 1.49 to 42.56; p=0.015) and cardiac involvement (AOR, 6.62; 1.08 to 40.63; p=0.041).

SRC was a major cause of death in patients with SSc, with prevalence rates of 12 to 18 percent in Western countries, until the late 1970s. Since then, the development of angiotensin-converting enzyme inhibitors (ACEI) has greatly helped in improving outcomes in SRC, as well as reducing the frequency of SRC. However, while ACEI has shown efficacy in managing SRC, the morbidities and mortalities from SRC remain high. [Ann Rheum Dis 2007;66:940–4; Semin Arthritis Rheum 2015;44:687–94; Ann Rheum Dis 2010;69:1809–15]

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Most Read Articles
01 Nov 2013

Joint stiffness is defined as discomfort after a period of inactivity. It is associated with reduced or loss of range of motion in a joint.

Stephen Padilla, 25 Nov 2016
The addition of supervised physiotherapy to usual care does not provide clinically important improvement in the management of simple ankle sprains in a general population of patients seeking hospital-based acute care, according to results of a recent randomized controlled trial.
24 Jul 2017
The toxic side-effects of chemotherapy appear to be induced by cell-free chromatin (cfCh) fragments released from dying cells, triggering DNA damage, apoptosis and inflammation in healthy cells, thereby exaggerating or amplifying the toxic effects caused by the drugs themselves, according to a study.