SCLERODERMA 101. Maureen D. Mayes, MD, MPH Professor of Medicine University of Texas - Houston
|
|
- Charity Carson
- 6 years ago
- Views:
Transcription
1 SCLERODERMA 101 Maureen D. Mayes, MD, MPH Professor of Medicine University of Texas - Houston
2 TYPES OF SCLERODERMA Localized versus Systemic
3 Two Kinds of Scleroderma Localized Scleroderma Morphea Linear Scleroderma En coupe de sabre Combinations Systemic Scleroderma (SSc, Systemic sclerosis) Limited cutaneous (lcssc) Diffuse cutaneous (dcssc)
4 MORPHEA
5 LOCALIZED SCLERODERMA (not Systemic) Involves the skin and underlying tissue usually does not involve internal organs Linear Scleroderma a line of thickened skin down one leg or arm Scleroderma en coup de sabre (cut of the saber) a line of thickened skin involving the scalp, forehead and the face Morphea: Patches of thickened skin anywhere on the body Can be a single patch or multiple patches
6 LOCALIZED SCLERODERMA (not Systemic) Involves the skin and underlying tissue usually does not involve internal organs Linear Scleroderma a line of thickened skin down one leg or arm Scleroderma en coup de sabre (cut of the saber) a line of thickened skin involving the scalp, forehead and the face Morphea: Patches of thickened skin anywhere on the body Can be a single patch or multiple patches
7 LOCALIZED SCLERODERMA (not Systemic) Involves the skin and underlying tissue usually does not involve internal organs Linear Scleroderma a line of thickened skin down one leg or arm Scleroderma en coup de sabre (cut of the saber) a line of thickened skin involving the scalp, forehead and the face Morphea: Patches of thickened skin anywhere on the body Can be a single patch or multiple patches
8 LOCALIZED SCLERODERMA (not Systemic) Involves the skin and underlying tissue usually does not involve internal organs Linear Scleroderma a line of thickened skin down one leg or arm Scleroderma en coup de sabre (cut of the saber) a line of thickened skin involving the scalp, forehead and the face Morphea: Patches of thickened skin anywhere on the body Can be a single patch or multiple patches
9 Systemic Sclerosis (SSc) Limited versus Diffuse Disease
10 RAYNAUD S PHENOMENON: Pallor Phase
11 RAYNAUD S PHENOMENON: Pallor and Cyanosis
12 TWO FACES OF Systemic SCLERODERMA (SSc)
13 Diffuse Scleroderma
14 Diffuse Cutaneous SSc Skin thickening upper arms, thighs, trunk in addition to hands and distal extremities 40% of SSc cases More likely to be associated with progressive lung fibrosis, and/or scleroderma renal crisis, and/or significant GI disease, and/or cardiac disease Each patient is different
15 Telangiectasia of Limited SSc
16 Limited Cutaneous SSc Skin thickening confined to distal extremities (both forms can involve the face) Usually has more mild internal organ disease Associated with anticentromere antibodies Sometimes called CREST for Calcinosis, Raynaud s, Esophageal Dysmotility, Sclerodactyly, and Telangiectasias.
17 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
18 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
19 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
20 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
21 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
22 ORGAN INVOLVEMENT in SSc Raynaud s phenomenon and digital ulcers Pulmonary fibrosis Pulmonary hypertension Cardiac involvement Gastroesophageal (GI) problems Joint problems Other
23 The Causes of SSc What we know & What we don t know
24 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
25 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
26 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
27 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
28 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
29 The Causes of SSc What we know: Some genes increase susceptibility but are not enough The Immune system is activated Small blood vessels start to narrow Deep skin cells (fibroblasts) increase collagen production What we don t know: The external trigger that starts the process The key points in the process that can be interrupted to stop the disease
30 THE TREATMENT OF Scleroderma
31 Treatment of MORPHEA
32 The Treatment of Localized Scleroderma Is it active? Intralesional steroids Methotrexate Other immunosuppressive medications Risk versus benefit ratio
33 RISKS > BENEFITS
34 RISKS = BENEFITS
35 RISKS << BENEFITS
36 TREATMENT OF Systemic Scleroderma Therapy depends on the organs involved
37 What are the treatment goals? Skin decrease thickening (fibrosis) Tendons and joints decrease inflammation Raynaud s phenomenon improve circulation Digital ulcers improve circulation Pulmonary fibrosis decrease scar tissue (fibrosis) Pulmonary hypertension improve circulation Gastrointestinal involvement esophagus, stomach, bowel decrease acid, improve motion, treat bacterial overgrowth Kidney involvement control blood pressure
38 What are the treatment goals? Skin decrease thickening (fibrosis) Tendons and joints decrease inflammation Raynaud s phenomenon improve circulation Digital ulcers improve circulation Pulmonary fibrosis decrease scar tissue (fibrosis) Pulmonary hypertension improve circulation Gastrointestinal involvement esophagus, stomach, bowel decrease acid, improve motion, treat bacterial overgrowth Kidney involvement control blood pressure
39 What are the treatment goals? Skin decrease thickening (fibrosis) Tendons and joints decrease inflammation Raynaud s phenomenon improve circulation Digital ulcers improve circulation Pulmonary fibrosis decrease scar tissue (fibrosis) Pulmonary hypertension improve circulation Gastrointestinal involvement esophagus, stomach, bowel decrease acid, improve motion, treat bacterial overgrowth Kidney involvement control blood pressure
40 What are the treatment goals? Skin decrease thickening (fibrosis) Tendons and joints decrease inflammation Raynaud s phenomenon improve circulation Digital ulcers improve circulation Pulmonary fibrosis decrease scar tissue (fibrosis) Pulmonary hypertension improve circulation Gastrointestinal involvement esophagus, stomach, bowel decrease acid, improve motion, treat bacterial overgrowth Kidney involvement control blood pressure
41 All SSc Patients are Different Each person is likely to have a different combination of problems So each person may be on a different combination of medications Some may be on little or no medicine Others are on tons of medicine
42 WHAT YOU CAN DO Learn about the disease Keep track of your test results Ask questions Participate in trials
43 QUESTIONS, CONCERNS, ISSUES
Scleroderma Facts. The Scleroderma Foundation is here to help!
Scleroderma Facts Scleroderma is an autoimmune disease whose symptoms typically include some or all of the following: sensitivity to cold in extremities, thickening of the skin, shortness of breath, difficulty
More informationSCLERODERMA: An Update. What You Need To Know
SCLERODERMA: An Update What You Need To Know Pre Test Question #1 The onset of systemic sclerosis is typically: A. In the 1st decade of life B. Between the 4th and 6th decade C. Equal in all age groups
More informationScleroderma. Nomenclature Synonyms. Scleroderma. Progressive Systemic Sclerosis. Systemic Sclerosis. Edward Dwyer, M.D. Division of Rheumatology
Scleroderma Edward Dwyer, M.D. Division of Rheumatology Nomenclature Synonyms Scleroderma Progressive Systemic Sclerosis Systemic Sclerosis Scleroderma 1 Scleroderma Chronic systemic autoimmune disease
More informationScleroderma. Nomenclature Synonyms. Scleroderma. Progressive Systemic Sclerosis. Systemic Sclerosis. Limited vs. Diffuse Scleroderma.
Scleroderma Edward Dwyer, M.D. Division of Rheumatology Nomenclature Synonyms Scleroderma Progressive Systemic Sclerosis Systemic Sclerosis Scleroderma Chronic systemic autoimmune disease characterized
More informationSystemic sclerosis (SSC)
Systemic sclerosis (SSC) -Is a multi system autoimmune disease, characterized by fibrosis of the skin and variable pattern of other visceral -SSC: Is a relatively UN common disease -Prevalence in U S A
More informationSCLERODERMA. Scleroderma update. No disclosures or conflicts. Leslie Kahl, M.D. April 10, 2015
Scleroderma update Leslie Kahl, M.D. April 10, 2015 No disclosures or conflicts KT is a 45 year old woman who developed puffiness in her fingers 1/2013 and carpal tunnel syndrome and arthralgias 3/2013.
More informationScleroderma FAQ. About this Document
Scleroderma FAQ About this Document The Scleroderma FAQ * is a comprehensive document that covers systemic scleroderma diagnosis and treatment. All information contained in the FAQ is based on current
More informationSystemic sclerosis and GI involvement
Systemic sclerosis and GI involvement Dr Maggie Larché, MRCP(UK), PhD Associate Professor, Division of Rheumatology, McMaster University St Joseph s Hospital Scleroderma CME, St Joseph s Hospital, September
More informationAcademic Affiliate Fellowship Practice Exam: 2018
Academic Affiliate Fellowship Practice Exam: 2018 Current History: A patient presents to your practice complaining of a tight feeling in her perioral tissue area. She is unable to open her mouth fully
More informationWhat will we discuss today?
Autoimmune diseases What will we discuss today? Introduction to autoimmune diseases Some examples Introduction to autoimmune diseases Chronic Sometimes relapsing Progressive damage Epitope spreading more
More informationassociated conditions a closer look at connective tissue disease and PAH
associated conditions a closer look at connective tissue disease and PAH The link between connective tissue disease and PAH Those living with a connective tissue disease (CTD) have an increased risk of
More informationBSR and BHPR guideline for the treatment of systemic sclerosis
BSR and BHPR guideline for the treatment of systemic sclerosis Christopher P. Denton, Michael Hughes, Nataliya Gak, Josephine Vila, Maya Buch, Kuntal Chakravarty, Kim Fligelstone, Luke L Gompels, Bridget
More informationChapter 1 Introduction
Chapter 1 Introduction Chapter 1-1 Chapter Highlights 1. This Manual is for You 2. What is Scleroderma? 3. Who gets Scleroderma? 4. What are the Early Symptoms of Scleroderma? 5. Is All Scleroderma the
More informationUnderstanding and Managing. Scleroderma. Maureen D. Mayes, M.D., M.P.H.
Understanding and Managing Scleroderma Maureen D. Mayes, M.D., M.P.H. Understanding and Managing Scleroderma Maureen D. Mayes, M.D., M.P.H. Understanding and Managing Scleroderma This booklet is intended
More informationhttps://www.printo.it/pediatric-rheumatology/gb/intro Scleroderma Version of 2016 1. WHAT IS SCLERODERMA 1.1 What is it? The name scleroderma is derived from Greek and can be translated as "hard skin".
More informationAutoimmune diseases. SLIDE 3: Introduction to autoimmune diseases Chronic
SLIDE 3: Introduction to autoimmune diseases Chronic Autoimmune diseases Sometimes relapsing : and remitting. which means that they present as attacks Progressive damage Epitope spreading more and more
More informationDocSpot what patients want to know
DocSpot what patients want to know Professor Chris Denton Royal Free Hospital London, UK Madrid, February 2012 Copyright 2011 Raynaud's & Scleroderma Association. Charity Reg. No. 326306 DocSpot Live!
More informationHaving a stem cell transplant for scleroderma a patient and doctor perspective
Having a stem cell transplant for scleroderma a patient and doctor perspective Professor Chris Denton, On behalf of an excellent team across UCLPartners Royal Free Hospital and University College London,
More informationMyositis and Your Lungs
Myositis and Your Lungs 2013 TMA Annual Patient Meeting Louisville, Kentucky Chester V. Oddis, MD University of Pittsburgh Director, Myositis Center Myositis Heterogeneous group of autoimmune syndromes
More informationB. Scleroderma. 6. Nodular cutaneous lupus mucinosis. 7. Bullous lupus erythematosus. 1. Systemic sclerosis (SSc)
Go Back to the Top To Order, Visit the Purchasing Page for Details antiodies. Symptomatic therapies for the eruptions and the systemic symptoms are the main treatments. A pacemaker may e implanted in patients
More informationScleroderma and PAH Overview. PH Resource Network Martha Kingman, FNP C UTSW Medical Center at Dallas
Scleroderma and PAH Overview PH Resource Network 2007 Martha Kingman, FNP C UTSW Medical Center at Dallas Scleroderma and PAH Outline: Lung involvement in scleroderma Evaluation of the scleroderma patient
More informationFor Your Information. This booklet is not copyrighted. Readers are encouraged to duplicate and distribute as many copies as needed.
H A N D O U T O N H E A L T H Scleroderma U.S. Department of Health and Human Services National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases For Your Information
More informationCASE STUDY. Improving the Patient Flow of Scleroderma Patients at Chapel Allerton Hospital. Client: Diagnostic Evidence Co-operative (DEC) Leeds
CSE STUDY Improving the Patient Flow of Scleroderma Patients at Chapel llerton Hospital Client: Diagnostic Evidence Co-operative (DEC) Leeds 1 NETIMIS Overview Chapel llerton Hospital is a leader in the
More informationCaring for the Patient With Limited Systemic Scleroderma
Caring for the Patient With Limited Systemic Scleroderma 2.0 ANCC Contact Hours Kelly Denise Lachner Systemic scleroderma (systemic sclerosis) is a rare, autoimmune, collagen-vascular disease of unknown
More informationA Comparison Between Anti-Th/To and Anticentromere Antibody Positive Systemic Sclerosis Patients With Limited Cutaneous Involvement
ARTHRITIS & RHEUMATISM Vol. 48, No. 1, January 2003, pp 203 209 DOI 10.1002/art.10760 2003, American College of Rheumatology A Comparison Between and Anticentromere Antibody Positive Systemic Sclerosis
More informationPeripheral (digital) vasculopathy in systemic. sclerosis. Ariane Herrick
Peripheral (digital) vasculopathy in systemic sclerosis Ariane Herrick Raynaud s phenomenon VASOPASM DEOXYGENATION REPERFUSION Main causes of RP Primary (idiopathic) Connective tissue diseases, including
More informationSCLERODERMA EPIDEMIOLOGY
1 SCLERODERMA Scleroderma is an autoimmune disorder of unknown etiology, characterized by fibrosis and microvascular injury in affected organs. The hallmark of the disease is thickening and tightness of
More informationMeasures of Systemic Sclerosis (Scleroderma)
Arthritis Care & Research Vol. 63, No. S11, November 2011, pp S98 S111 DOI 10.1002/acr.20598 2011, American College of Rheumatology MEASURES OF PATHOLOGY AND SYMPTOMS Measures of Systemic Sclerosis (Scleroderma)
More informationUnderstanding & Managing Scleroderma
Understanding & Managing Scleroderma UK Registered Charity Number 286736 Number 286736 Printing of this booklet was supported by grants from Actelion Pharmaceuticals UK and Encysive Pharmaceuticals Understanding
More informationScleroderma What is Scleroderma? What Causes Scleroderma? Who gets Scleroderma? What are the symptoms of Scleroderma? - 1 -
What is Scleroderma? Scleroderma means "hard skin". It is a disease of vascular and connective tissue where the skin and many other parts of the body can become thick and hard. There are two kinds of Scleroderma:
More informationJuvenile Scleroderma
Juvenile Scleroderma INTRODUCTION Every parent will experience a moment of panic when told their child has scleroderma. Often they hear little else the doctor has to say. A quick trip to the Internet may
More informationGuide for New and Future Patients
Guide for New and Future Patients About this Guide This Guide for New and Future Patients is a companion document to the Scleroderma FAQ TM, also available through the Scleroderma Education Project website:
More informationCitation The Journal of dermatology, 37(1), available at
NAOSITE: Nagasaki University's Ac Title Author(s) Case of localized scleroderma assoc Muroi, Eiji; Ogawa, Fumihide; Yamao Sato, Shinichi Citation The Journal of dermatology, 37(1), Issue Date 2010-01 URL
More informationUpdate in Systemic Sclerosis! Lauren Kim MD! NW Rheumatology Associates
Update in Systemic Sclerosis! Lauren Kim MD! NW Rheumatology Associates Review Systemic sclerosis affects approximately 75,000 to 100,000 people in the U.S. and has the highest mortality rate of any autoimmune
More informationA Patient s Guide to Understanding Pulmonary Arterial Hypertension in Systemic Sclerosis
A Patient s Guide to Understanding Pulmonary Arterial Hypertension in Systemic Sclerosis Compared with the general population, patients with systemic sclerosis (also known as scleroderma) have a higher
More informationReporting Autoimmune Diseases in Hematopoietic Stem Cell Transplantation
Reporting Autoimmune Diseases in Hematopoietic Stem Cell Transplantation Marcelo C. Pasquini, MD, MSc HVD05_1.ppt Outline Review of autoimmune diseases (AID). Role of transplantation for AID Data collection:
More informationPredictors of Isolated Pulmonary Hypertension in Patients With Systemic Sclerosis and Limited Cutaneous Involvement
ARTHRITIS & RHEUMATISM Vol. 48, No. 2, February 2003, pp 516 522 DOI 10.1002/art.10775 2003, American College of Rheumatology Predictors of Isolated Pulmonary Hypertension in Patients With Systemic Sclerosis
More information10 pearls in scleroderma for the family practitioner
10 pearls in scleroderma for the family practitioner Dr Maggie Larche, MRCP(UK), PhD Associate Professor, Division of Rheumatology, McMaster University St Joseph s Hospital Family Medicine Rounds, St Joseph
More informationThe First Year: Scleroderma: An Essential Guide For The Newly Diagnosed By Karen Gottesman, Daniel E. Furst
The First Year: Scleroderma: An Essential Guide For The Newly Diagnosed By Karen Gottesman, Daniel E. Furst Member - The Scleroderma Patient-centered Intervention Network - Author of The First Year: Scleroderma
More informationRHEUMATOLOGY OVERVIEW. Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center
RHEUMATOLOGY OVERVIEW Carmelita J. Colbert, MD Assistant Professor of Medicine Division of Rheumatology Loyola University Medical Center What is Rheumatology? Medical science devoted to the rheumatic diseases
More informationSupplementary Online Content
Supplementary Online Content Caglayan E, Axmann S, Hellmich M, Moinzadeh P, Rosenkranz S. Vardenafil for the treatment of Raynaud phenomenon: a randomized, double-blind, placebocontrolled crossover study.
More informationSCLERODERMA LUNG DISEASE: WHAT THE PATIENT SHOULD KNOW
SCLERODERMA LUNG DISEASE: WHAT THE PATIENT SHOULD KNOW Lung disease can be a serious complication of scleroderma. The two most common types of lung disease in patients with scleroderma are interstitial
More informationdifferent phenotypes
Pulmonary hypertension in scleroderma: different phenotypes UMR 995 Pr David LAUNAY, MD, PhD launayd@gmail.com Service de Médecine Interne. Unité d'immunologie Clinique CNRMR Maladies Systémiques et Autoimmunes
More informationMethodology used to develop new ACR-EULAR criteria. Disclosures. Objectives Guiding principles underlying methodology
Methodology used to develop new ACR-EULAR criteria Sindhu Johnson MD PhD Toronto Scleroderma Program University of Toronto Co-convenors Janet Pope Frank van den Hoogen Members Jaap Fransen Sindhu Johnson
More informationUnderstanding and Managing Scleroderma
Understanding and Managing Scleroderma FIRST SCLERODERMA NEW ZEALAND EDITION 2016 Understanding And Managing Scleroderma First Scleroderma New Zealand Edition 2016 Acknowledgement An acknowledgement of
More informationScleroderma. Chronic multisystemic disease characterized by vasculopathy, variable degree of inflammation, and fibrosis
Scleroderma Chronic multisystemic disease characterized by vasculopathy, variable degree of inflammation, and fibrosis Incidence 3.7-22.8 cases/million Female:male 5:1 Pulmonary fibrosis common, severe
More informationDisclosures. Scleroderma: Early Diagnosis How early is early? 10/28/2013. Difficult Scleroderma: How do I Approach this Patient?
Disclosures Financial support: None Difficult Scleroderma: How do I Approach this Patient? Francesco Boin, MD Assistant Professor of Medicine Director, Translational Research Johns Hopkins Scleroderma
More information2/23/18. Disclosures. Rheumatic Diseases of Childhood. Making Room for Rheumatology. I have nothing to disclose. James J.
Making Room for Rheumatology James J. Nocton, MD Disclosures I have nothing to disclose Rheumatic Diseases of Childhood Juvenile Idiopathic Arthritis (JIA) Systemic Lupus Erythematosus (SLE) Juvenile Dermatomyositis
More informationHYPERTENSIVE VASCULAR DISEASE
HYPERTENSIVE VASCULAR DISEASE Cutoffs in diagnosing hypertension in clinical practice sustained diastolic pressures >90 mm Hg, or sustained systolic pressures >140 mm Hg Malignant hypertension A small
More informationMEDICAL SURGICAL NURSING II VNRS B85 ASSESSING CLIENTS WITH PERIPHERAL VASCULAR AND LYMPHATIC DISORDERS
MEDICAL SURGICAL NURSING II VNRS B85 ASSESSING CLIENTS WITH PERIPHERAL VASCULAR AND INTRODUCTION: Clients with disorders of the peripheral vascular and lymphatic system experience a wide variety of circulatory
More informationSEVERE ORGAN INVOLVEMENT IN SYSTEMIC SCLEROSIS WITH DIFFUSE SCLERODERMA
ARTHRITIS & RHEUMATISM Vol. 43, No. 11, November 2000, pp 2437 2444 2000, American College of Rheumatology 2437 SEVERE ORGAN INVOLVEMENT IN SYSTEMIC SCLEROSIS WITH DIFFUSE SCLERODERMA VIRGINIA D. STEEN
More informationSystemic Sclerosis. Scleroderma
Systemic Sclerosis Scleroderma Definition Chronic systemic disorder Unknown etiology Thickening of the skin = scleroderma Involvement of multiple internal organs Early stage: inflammation Later stage:
More informationSclérodermie systémique: Manifestations musculosquelettiques
Sclérodermie systémique: Manifestations musculosquelettiques Benjamin Chaigne Service de Médecine Interne, hôpital Cochin, Centre de Référence Vascularites nécrosantes et sclérodermie systémique Assistance
More informationPrevalence of pulmonary hypertension in systemic sclerosis and it s correlation with clinical variables
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 9 Ver. X (September. 2017), PP 90-95 www.iosrjournals.org Prevalence of pulmonary hypertension
More informationAUTOIMMUNE DISORDERS IN THE ACUTE SETTING
AUTOIMMUNE DISORDERS IN THE ACUTE SETTING Diagnosis and Treatment Goals Aimee Borazanci, MD BNI Neuroimmunology Objectives Give an update on the causes for admission, clinical features, and outcomes of
More informationLUPUS CAN DO EVERYTHING, BUT NOT EVERYTHING IS LUPUS LUPUS 101 SLE SUBSETS AUTOIMMUNE DISEASE 11/4/2013 HOWARD HAUPTMAN, MD IDIOPATHIC DISCOID LUPUS
LUPUS 101 LUPUS CAN DO EVERYTHING, BUT NOT EVERYTHING IS LUPUS HOWARD HAUPTMAN, MD IDIOPATHIC DISCOID LUPUS SLE SUBSETS SUBACUTE CUTANEOUS LUPUS DRUG INDUCED LUPUS NEONATAL LUPUS LATE ONSET LUPUS ANTI-PHOSPHOLIPID
More informationArthritis & Rheumatism
ARTHRITIS & RHEUMATISM Volume 37 Number 9, September 1994, pp 1265-1282 0 1994, American College of Rheumatology Arthritis & Rheumatism Official Journal of the American College of Rheumatology REVIEW GASTROINTESTINAL
More informationBlood Hyperviscosity / Plasmapheresis
Blood Hyperviscosity / Plasmapheresis In 1979, a research paper authored by Kahaleh, Sherer, and LeRoy titled Endothelial Injury in Scleroderma included the following passage: Many theories exist regarding
More informationCigarette Smoking is not a Risk Factor for Systemic Sclerosis
Brief Report Arthritis & Rheumatism DOI 10.1002/art.30492 Cigarette Smoking is not a Risk Factor for Systemic Sclerosis Authors: Prateek Chaudhary 1, Xing Chen 2, Shervin Assassi 1, Olga Gorlova 2, Hilda
More informationAtypical Neuroimaging Manifestations of Linear Scleroderma en coup de sabre
Atypical Neuroimaging Manifestations of Linear Scleroderma en coup de sabre The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters.
More informationFunctional vascular disorders
Functional vascular disorders Raynaud s phenomenon Raynaud s phenomenon Refers to Intermittent,bilateral attacks of ischemia of the fingers or toes, and sometimes ears or nose. It clinically manifests
More informationTest Name Results Units Bio. Ref. Interval
135091660 Age 44 Years Gender Male 29/8/2017 120000AM 29/8/2017 100219AM 29/8/2017 105510AM Ref By Final EXTRACTABLENUCLEAR ANTIGENS (ENA), QUANTITATIVE ROFILE CENTROMERE ANTIBODY, SERUM 20-30 Weak ositive
More informationDr Ian Roberts Oxford
Dr Ian Roberts Oxford Oxford Pathology Course 2010 for FRCPath Present the basic diagnostic features of the commonest conditions causing renal failure Highlight diagnostic pitfalls. Crescentic GN: renal
More informationSevere Fibrosis and Increased Expression of Fibrogenic Cytokines in the Gastric Wall of Systemic Sclerosis Patients
ARTHRITIS & RHEUMATISM Vol. 56, No. 10, October 2007, pp 3442 3447 DOI 10.1002/art.22940 2007, American College of Rheumatology Severe Fibrosis and Increased Expression of Fibrogenic Cytokines in the Gastric
More informationThomas A. Medsger, Jr., MD University of Pittsburgh School of Medicine. Disclosures: None
Thomas A. Medsger, Jr., MD University of Pittsburgh School of Medicine Disclosures: None 4000+ patients enrolled 1972- present; 5+ visits per patient; 20,000+ patient years of follow- up All clinical and
More informationSCLERODERMA RENAL CRISIS. Presented by : Nouf Alanazi
SCLERODERMA RENAL CRISIS Presented by : Nouf Alanazi Agenda Prevalence Risk factors Pathology Diagnosis Prevention & monitoring Treatment Outcome & mortality. Summary & recommendations References SRC Abrupt
More informationJuvenile scleroderma: experience in one institution
Original article Juvenile scleroderma: experience in one institution Chia-Yi Lo 1, Shyh-Dar Shyur 1, Szu-Hung Chu 1, Li-Hsin Huang 1, Yu-Hsuan Kao 1, Wei-Te Lei 1, Chieh- Han Cheng 1, Kuo-Hsi Lee 1, Chen-Kuan
More informationNIH Public Access Author Manuscript Arthritis Rheum. Author manuscript; available in PMC 2014 November 01.
NIH Public Access Author Manuscript Published in final edited form as: Arthritis Rheum. 2013 November ; 65(11): 2737 2747. doi:10.1002/art.38098. Classification Criteria for Systemic Sclerosis: An ACR-EULAR
More informationMegha M. Tollefson, MD Associate Professor of Dermatology and Pediatrics, Mayo Clinic Pediatric Morphea March 1, MFMER
Megha M. Tollefson, MD Associate Professor of Dermatology and Pediatrics, Mayo Clinic Pediatric Morphea March 1, 2019 2015 MFMER 3513105-1 Disclosures None 2015 MFMER 3513105-2 Topics to cover Classification
More informationTest Name Results Units Bio. Ref. Interval
135091662 Age 45 Years Gender Male 29/8/2017 120000AM 29/8/2017 100215AM 29/8/2017 110825AM Ref By Final RHEUMATOID AUTOIMMUNE COMREHENSIVE ANEL ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF), SERUM ----- 20-60
More informationTest Name Results Units Bio. Ref. Interval
LL - LL-ROHINI (NATIONAL REFERENCE 135091593 Age 25 Years Gender Male 30/8/2017 91600AM 30/8/2017 93946AM 31/8/2017 84826AM Ref By Final COLLAGEN DISEASES ANTIBODY ANEL ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF),
More informationArtery 1 Head and Thoracic Arteries. Arrange the parts in the order blood flows through them.
Artery 1 Head and Thoracic Arteries 1. Given the following parts of the aorta: 1. abdominal aorta 2. aortic arch 3. ascending aorta 4. thoracic aorta Arrange the parts in the order blood flows through
More informationTRANSPARENCY COMMITTEE OPINION. 23 January 2008
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 23 January 2008 TRACLEER 62.5 mg film-coated tablets Pack of 56 (CIP: 563 621-1) TRACLEER 125 mg film-coated tablets
More informationCyramza. Cyramza (ramucirumab) Description. Section: Prescription Drugs Effective Date: October 1, 2014
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Cyramza Page: 1 of 5 Last Review Date: September 12, 2014 Cyramza Description Cyramza (ramucirumab)
More informationDefinition Chronic autoimmune disease The body s immune system starts attacking itself Can affect most organs and tissues in the body Brain, lungs, he
LIVING WITH SYSTEMIC LUPUS ERYTHEMATOSUS Stacy Kennedy, M.D.,M.B.A. Rowan Diagnostic Clinic Salisbury, N.C. May 11, 2013 Agenda What is lupus Who is affected Causes of lupus Symptoms and organ involvement
More informationA clinical syndrome, composed mainly of:
Nephritic syndrome We will discuss: 1)Nephritic syndrome: -Acute postinfectious (poststreptococcal) GN -IgA nephropathy -Hereditary nephritis 2)Rapidly progressive GN (RPGN) A clinical syndrome, composed
More informationDRG Code DRG Description FY18 Average Charge
DRG Code DRG Description FY18 Average Charge 3 ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O $ 665,511 4 TRACH W MV 96+ HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. $ 422,497 37 EXTRACRANIAL
More information3 Circulatory Pathways
40 Chapter 3 Circulatory Pathways Systemic Arteries -Arteries carry blood away from the heart to the various organs of the body. -The aorta is the longest artery in the body; it branches to give rise to
More informationScholars Journal of Medical Case Reports
Scholars Journal of Medical Case Reports Sch J Med Case Rep 2015; 3(9B):928-932 Scholars Academic and Scientific Publishers (SAS Publishers) (An International Publisher for Academic and Scientific Resources)
More informationPremium Specialty: Pediatrics
Premium Specialty: Pediatrics Credentialed Specialties include: Adolescent Medicine, Pediatric Adolescent, and Pediatrics This document is designed to be used in conjunction with the UnitedHealth Premium
More informationA number of factors point to the likelihood of a person with RA developing RV:
What is rheumatoid vasculitis (RV)? Rheumatoid vasculitis (RV) is a rare but serious complication of rheumatoid arthritis (RA) an inflammatory disease that causes severe joint pain and damage, and can
More informationRegressive systemic sclerosis
Annals of the Rheumatic Diseases, 1986; 45, 384-388 Regressive systemic sclerosis CAROL BLACK, PAUL DIEPPE, TED HUSKISSON, AND FRANK DUDLEY HART From the Departments of Medicine and Rheumatology, West
More informationSecondary Raynaud s Phenomenon
Secondary Raynaud s Phenomenon Ulf Müller-Ladner University of Giessen Kerckhoff Clinic Bad Nauheim Germany Clinical problems in SSc Therapeutic solutions? Pulmonary fibrosis + PAH Diffuse Pulmonary fibrosis,
More informationPDF of Trial CTRI Website URL -
Clinical Trial Details (PDF Generation Date :- Fri, 09 Nov 2018 00:53:13 GMT) CTRI Number Last Modified On 30/07/2014 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study
More informationSummary of the risk management plan (RMP) for Kyprolis (carfilzomib)
EMA/639793/2015 Summary of the risk management plan (RMP) for Kyprolis (carfilzomib) This is a summary of the risk management plan (RMP) for Kyprolis, which details the measures to be taken in order to
More informationTracheoesophageal Fistula and Esophageal Atresia
Patient and Family Education Tracheoesophageal Fistula and Esophageal Atresia What is tracheoesophageal fistula? The word fistula means abnormal connection. Tracheoesophageal fistula (TEF) is a condition
More informationLong-Term (22 Year) Successful Treatment of Limited Systemic Scleroderma Using Plasmapheresis
Long-Term (22 Year) Successful Treatment of Limited Systemic Scleroderma Using Plasmapheresis Edward S. Harris MS, Herbert Meiselman ScD, Patrick M Moriarty MD, John Weiss MD PhD Abstract While a number
More informationATHEROSCLEROSIS. Secondary changes are found in other coats of the vessel wall.
ATHEROSCLEROSIS Atherosclerosis Atherosclerosis is a disease process affecting the intima of the aorta and large and medium arteries, taking the form of focal thickening or plaques of fibrous tissue and
More informationJournal of Pediatric Sciences
Journal of Pediatric Sciences Progressive facial hemiatrophy with contralateral maxillary mucocele Mohd Ashraf, Sheikh Javeed Sultan, Javed Ahmad Journal of Pediatric Sciences 2010;2:e11 How to cite this
More informationNon-commercial use only
Reumatismo, 2015; 67 (1): 21-25 Systemic sclerosis sine scleroderma: a of anterior uveitis T. Borges, J. Vilaça, S. Ferreira, I. Chora, S. Silva, C. Dias Internal Medicine Department, Centro Hospitalar
More informationChronic Radiodermatitis Following Percutaneous Coronary Interventions
Chronic Radiodermatitis Following Percutaneous Coronary Interventions Jung-Yi Chan Chia-Yu Chu The incidence of radiodermatitis after percutaneous coronary interventions is rising with the increasing number
More informationSystemic sclerosis. Novel molecular and epidemiological features of disease.
Systemic sclerosis. Novel molecular and epidemiological features of disease. Andréasson, Kristofer Published: 2013-01-01 Link to publication Citation for published version (APA): Andréasson, K. (2013).
More informationStem Cell Transplantation (SCT) in Scleroderma
Stem Cell Transplantation (SCT) in Scleroderma Yes or No? Philippe Guilpain, MD, PhD Department of Internal Medicine- Multiorganic diseases Competence center for auto-immune diseases Saint Eloi Hospital,
More informationHuman Body Systems. Human Body Project Notes
Human Body Systems Human Body Project Notes Human Body Organ Systems for the Project Big Idea: Organ systems are composed of organs that are made of more than one type of tissue. Tissues are made of one
More informationScleroderma renal crisis following silicone breast implant rupture: a case report and review of the literature
CASE REPORT Clinical and Experimental Rheumatology 2014; 32: 262-266. Scleroderma renal crisis following silicone breast implant rupture: a case report and review of the literature G. Al Aranji¹, D. White¹,
More informationIncidental Esophageal Findings on Chest CT. Amira Hussien, MD, Elliot Fishman, MD, Bouchra Younes, MD, Ahmed Hatw. Johns Hopkins Medical Institution
Incidental Esophageal Findings on Chest CT Amira Hussien, MD, Elliot Fishman, MD, ouchra Younes, MD, Ahmed Hatw. Johns Hopkins Medical Institution I have nothing to disclose. DISCLOSURE INTRODUCTION Although
More informationBMI ( ) kg / m 2 (P < 0.001) OSAS ( ) ( ) cm P < OSAS OSAS
CHEST Luca Busetto, MD; Giuliano Enzi, MD; Emine Meral Inelmen, MD; Gabriella Costa, MD; Valentina Negrin, MD; Giuseppe Sergi, MD; and Andrea Vianello, MD (OSAS) OSAS 17 OSAS (BMI) (55.8 9.9) kg / m 2
More informationAPR-DRG Description Ave Charge
Abdominal Pain 16,500.25 2.8 6,000.09 Acute & Subacute Endocarditis 15,339.30 3.0 5,113.10 Acute Myocardial Infarction 17,687.46 2.6 6,802.87 Alcohol Abuse & Dependence 19,126.64 4.2 4,553.96 Alcoholic
More informationIntroduction. Results. Discussion. Histopathologic and immunohistochemical findings. Results. conclusions,
1/5 2/5 Carcinoma distinctive carcinoma. form erysipeloides (CE), metastasis. which clinically Itfrom has resembles been termed erysipelas, is an uncommon, but may extend It164 toclassically back, presents
More information