Document Detail


Cerebral vasculopathy is associated with severe vascular manifestations in systemic sclerosis.
MedLine Citation:
PMID:  19531752     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate brain involvement in patients with systemic sclerosis (SSc). METHODS: Sixty-three patients with SSc fulfilling the American College of Rheumatology and/or Leroy and Medsger criteria were retrospectively studied, including 30 (47.6%) with limited cutaneous and 27 (42.9%) with diffuse cutaneous SSc. Forty-one patients underwent computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain, 11 patients only CT scan, and the remaining 11 patients only MRI. Cerebral vasculopathy on MRI and CT scan was defined as absent or mild (score < 1), moderate (1 <or= score < 2), or severe (score >or= 2) on a 4-point scale (0 to 3). RESULTS: Cerebral vasculopathy was identified on CT scan in 22 patients (moderate in 12 and severe in 10) and on MRI in 38 patients (moderate in 28 and severe in 10). Patients with severe cerebral vasculopathy seen on MRI were more likely to have pulmonary arterial hypertension (PAH; p = 0.003) and showed a tendency to have scleroderma renal crisis (SRC; p = 0.25, test for trend p = 0.097). A similar association was found between severe cerebral vasculopathy seen on CT scan and PAH (p = 0.026) or SRC (p = 0.04). After adjusting for age and hypertension, severe cerebral vasculopathy was still associated with increased risk of severe vascular manifestations [odds ratio (OR) 32, 95% confidence interval (CI) 3.45-297, p = 0.002 for CT scan; OR 26, 95% CI 1.71-394, p = 0.019 for MRI]. CONCLUSION: Severe cerebral vasculopathy is associated with severe vascular manifestations in SSc patients. SSc patients with severe vascular complications should undergo neuroradiological imaging assessment of brain involvement.
Authors:
Benjamin Terrier; Frédérique Charbonneau; Emmanuel Touzé; Alice Berezne; Christian Pagnoux; Stéphane Silvera; Jean-François Meder; Loïc Guillevin; Catherine Oppenheim; Luc Mouthon
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-16
Journal Detail:
Title:  The Journal of rheumatology     Volume:  36     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-01     Completed Date:  2009-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  1486-94     Citation Subset:  IM    
Affiliation:
Descartes University, Faculty of Medicine, Department of Internal Medicine and French Reference Centre for Necrotizing Vasculitides and Systemic Sclerosis, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75679 Paris Cedex 14, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Brain / blood supply*,  pathology*
Cerebrovascular Disorders / etiology*,  pathology,  radiography
Female
Humans
Hypertension, Pulmonary / epidemiology
Kidney Diseases / epidemiology
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk Factors
Scleroderma, Systemic / complications*
Tomography, X-Ray Computed
Young Adult

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