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 NICE NG78 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 NICE NG78.
- Cardiac complications: These include arrhythmias, pericarditis, and myocardial fibrosis, which can contribute to heart failure and require cardiac monitoring NICE NG78.
- Gastrointestinal involvement: Esophageal dysmotility, gastroesophageal reflux disease, and malabsorption are common and should be assessed routinely NICE NG78.
- Musculoskeletal issues: Joint contractures, muscle weakness, and tendon friction rubs are frequent and impact function NICE NG78.
- Skin changes: Progressive skin thickening and digital ulcers are hallmark features that need ongoing evaluation NICE NG78.
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 NICE NG78.
Key References
- NG78 - Cystic fibrosis: diagnosis and management
- NG130 - Ulcerative colitis: management
- NG100 - Rheumatoid arthritis in adults: management
- CG143 - Sickle cell disease: managing acute painful episodes in hospital
- (Cole et al., 2023): Renal Disease and Systemic Sclerosis: an Update on Scleroderma Renal Crisis.