What are the common complications of systemic sclerosis that I should monitor for in my patients?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Common complications of systemic sclerosis to monitor include:

  • Renal involvement: Scleroderma renal crisis is a serious complication characterised by sudden onset of hypertension and rapidly progressive renal failure, requiring urgent recognition and management .
  • Pulmonary complications: Interstitial lung disease and pulmonary arterial hypertension are frequent and major causes of morbidity and mortality in systemic sclerosis, necessitating regular respiratory assessment .
  • Cardiac complications: These include arrhythmias, pericarditis, and myocardial fibrosis, which can contribute to heart failure and require cardiac monitoring .
  • Gastrointestinal involvement: Esophageal dysmotility, gastroesophageal reflux disease, and malabsorption are common and should be assessed routinely .
  • Musculoskeletal issues: Joint contractures, muscle weakness, and tendon friction rubs are frequent and impact function .
  • Skin changes: Progressive skin thickening and digital ulcers are hallmark features that need ongoing evaluation .

Overall, vigilant monitoring for renal crisis is critical due to its acute nature and potential severity, supported by recent literature emphasising updated understanding of renal disease mechanisms in systemic sclerosis . Pulmonary and cardiac complications remain key areas of focus in line with UK clinical guidelines .

Educational content only. Always verify information and use clinical judgement.