Thanks to the rampant spread of COVID-19, many events, symposiums, and clinics moved online. One was the 2020 ACR State-of-the-Art Clinical Symposium, in which participants discuss diagnostic information, treatments, and other issues pertaining to rheumatology. This year, Dr. Francesco Boin, MD, presented on how to identify and manage three scleroderma-related emergencies: critical digital ischemia, scleroderma renal crisis, and intestinal pseudo-obstruction. According to The Rheumatologist, understanding this can better patient care and thus improve patient outcomes.
Scleroderma is a group of rare diseases characterized by the stiffening/hardening of skin and connective tissues throughout the body. Though researchers know it is caused by excess collagen production, they are still unsure as to what causes that excess. Currently, scleroderma is split into 2 subsets:
- Localized, a mild form in which only a few patches of skin or muscles are impacted.
- Systemic, a more severe form which can widely affected the skin, lungs, kidneys, heart, blood vessels, muscles, joints, stomach, and bowels.
In some cases, scleroderma presents abnormally. As a result, while some experience hard and tight skin patches, others may experience symptoms such as:
- A decline in kidney, heart, and lung function
- Acid reflux
- Esophageal damage
- Problems with nutrient absorption
- Raynaud’s phenomenon
- Numbness and pain in the fingers and toes
Learn more about scleroderma here.
Identifying and Managing Rheumatological Emergencies
According to Dr. Boin, there are three main types of scleroderma-related emergencies: critical digital ischemia, scleroderma renal crisis, and intestinal pseudo-obstruction. In better understanding these issues, doctors will be better poised to improve patient health.
Critical Digital Ischemia
According to an article in Seminars in Arthritis and Rheumatism, critical digital ischemia is:
Scleroderma Renal Crisis
characterised by new-onset malignant hypertension and progressive acute renal failure, often with associated microangiopathic haemolytic anaemia and thrombocytopenia.