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Semin Arthritis Rheum. 2016 Dec;46(3):344-349. doi: 10.1016/j.semarthrit.2016.05.008. Epub 2016 Jun 2.

Calcinosis is associated with digital ulcers and osteoporosis in patients with systemic sclerosis: A Scleroderma Clinical Trials Consortium study.

Author information

1
Department of Immunology and Rheumatology, Stanford University School of Medicine, 1000 Welch Road, Suite 203 MC 5755, Palo Alto, CA 94304.
2
Department of Rheumatology, Jewish General Hospital McGill University, Montreal, Canada.
3
Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
4
Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia; Department of Rheumatology, St. Vincent׳s Hospital Melbourne, Fitzroy, Australia.
5
Discipline of Medicine, University of Adelaide, Adelaide, Australia; Department of Rheumatology, St. Vincent׳s Hospital Melbourne, Fitzroy, Australia.
6
Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, DF, Mexico, Mexico.
7
Unit and Chair of Rheumatology, University Hospital of Cagliari, Cagliari, Italy.
8
Department of Medicine/Rheumatology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
9
Department of Rheumatology, Northwestern University, Chicago, IL.
10
Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
11
Department of Endocrinology, Stanford University School of Medicine, Palo Alto, CA.
12
Department of Dermatology, Stanford University School of Medicine, Palo Alto, CA.
13
Department of Immunology and Rheumatology, Stanford University School of Medicine, 1000 Welch Road, Suite 203 MC 5755, Palo Alto, CA 94304. Electronic address: shauwei@stanford.edu.

Abstract

OBJECTIVES:

We sought to identify the clinical factors associated with calcinosis in an international multicenter collaborative effort with the Scleroderma Clinical Trials Consortium (SCTC).

METHODS:

This is a retrospective cohort study of 5218 patients with systemic sclerosis (SSc). Logistic regression was used to obtain odds ratios (OR) relating calcinosis to various clinical features in multivariate analyses.

RESULTS:

A total of 1290 patients (24.7%) had calcinosis. In univariate analyses, patients with calcinosis were older than patients without calcinosis, more likely to be female, and had longer disease duration from the first non-Raynaud phenomenon symptom. Patients with calcinosis were more likely to have digital ulcers, telangiectasias, acro-osteolysis, cardiac disease, pulmonary hypertension, gastrointestinal involvement, arthritis, and osteoporosis, but less likely to have muscle disease. Anti-Scl-70, RNA-polymerase-III, and U1-RNP autoantibodies were significantly less common in patients with calcinosis, while anticentromere (ACA), anti-PM/Scl, and anticardiolipin antibodies were more frequent. In multivariate analysis, the strongest associations with calcinosis were digital ulcers (OR = 3.9; 95% CI: 2.7-5.5; p < 0.0001) and osteoporosis (OR = 4.2; 95% CI: 2.3-7.9; p < 0.0001).

CONCLUSION:

One quarter of patients with SSc have calcinosis at some time during their illness. Our data confirm a strong association of calcinosis with digital ulcers, and support a novel association with osteoporosis.

KEYWORDS:

Calcinosis; Digital ulcers; Osteoporosis; Systemic sclerosis

PMID:
27371996
PMCID:
PMC5500288
DOI:
10.1016/j.semarthrit.2016.05.008
[Indexed for MEDLINE]
Free PMC Article

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