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

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 ¹ (Cole et al., 2023).
• 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 ¹.
• Cardiac complications: These include arrhythmias, pericarditis, and myocardial fibrosis, which can contribute to heart failure and require cardiac monitoring ¹.
• Gastrointestinal involvement: Esophageal dysmotility, gastroesophageal reflux disease, and malabsorption are common and should be assessed routinely ¹.
• Musculoskeletal issues: Joint contractures, muscle weakness, and tendon friction rubs are frequent and impact function ¹.
• Skin changes: Progressive skin thickening and digital ulcers are hallmark features that need ongoing evaluation ¹.

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 (Cole et al., 2023). Pulmonary and cardiac complications remain key areas of focus in line with UK clinical guidelines ¹.