Clinical Rheumatology

, Volume 38, Issue 11, pp 3189–3193 | Cite as

Acroosteolysis and bone metabolism parameters distinguish female patients with limited systemic sclerosis with and without calcinosis: a case control study

  • Marilia M. Sampaio-Barros
  • Lorena C. M. Castelo Branco
  • Liliam Takayama
  • Marco Antonio G. Pontes Filho
  • Percival D. Sampaio-Barros
  • Rosa Maria R. PereiraEmail author
Brief Report
Part of the following topical collections:
  1. Updates in Systemic Sclerosis


Calcinosis usually represents a late manifestation of systemic sclerosis (SSc), inducing tissue damage and chronic calcifications. To analyze clinical and bone metabolism parameters associated with calcinosis in limited systemic sclerosis (lSSc), thirty-six female lSSc patients with calcinosis were compared with 36 female lSSc patients without calcinosis, matched by age, disease duration, and body mass index. Organ involvement, autoantibodies, bone density, and laboratory parameters were analyzed. Statistical significance was considered if p < 0.05. Calcinosis was significantly associated with acroosteolysis (69% vs. 22%, p < 0.001), higher modified Rodnan skin score (mRSS 4.28 ± 4.66 vs. 1.17 ± 2.50, p < 0.001), and higher 25-hydroxyvitamin D (25OHD) (24.46 ± 8.15 vs. 20.80 ± 6.60 ng/ml, p = 0.040) and phosphorus serum levels (3.81 ± 0.41 vs. 3.43 ± 0.45 mg/dl, p < 0.001). 25OHD levels > 30 ng/ml were also significantly more frequent in patients with calcinosis (p = 0.041). Regarding treatment, current use of corticosteroids was lower in patients with calcinosis compared with patients without calcinosis (8% vs. 28%, p = 0.032). On logistic regression analysis, acroosteolysis (OR = 12.04; 95% CI, 2.73–53.04; p = 0.001), mRSS (OR = 1.37; 95% CI, 1.11–1.69; p = 0.003), phosphorus serum levels (OR = 5.07; 95% CI, 1.06–24.23; p = 0.042), and lower glucocorticoid use (OR = 0.07; 95% CI, 0.007–0.66; p = 0.021) are independent risk factors for calcinosis. This study showed that limited SSc patients with calcinosis present a distinct clinic and biochemical profile when compared with a matched group without calcinosis, paired by disease duration, age and BMI.

Key Points

Calcinosis in patients with limited SSc was associated with acroosteolysis, higher mRSS and higher serum levels of phosphorus.


Acroosteolysis Calcinosis Limited systemic sclerosis 


Support and grants

This work was supported by grants from Programa Nacional de Pós-Doutorado da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (PNPD/ CAPES) (no. 1412229 to M.M.S.B.) and Federico Foundation (to P.D.S.B. and R.M.R.P.).

Compliance with ethical standards

All patients gave their written informed consent, and the study was approved by the Ethics Research Committee of the University of São Paulo (Research protocol 0819/10).




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  • Marilia M. Sampaio-Barros
    • 1
  • Lorena C. M. Castelo Branco
    • 1
  • Liliam Takayama
    • 1
  • Marco Antonio G. Pontes Filho
    • 1
  • Percival D. Sampaio-Barros
    • 1
  • Rosa Maria R. Pereira
    • 1
    • 2
    Email author
  1. 1.Division of RheumatologyHospital das Clinicas HCFMUSP Faculdade de Medicina da Universidade de Sao PauloSao PauloBrazil
  2. 2.Disciplina de ReumatologiaFaculdade Medicina da Universidade de Sao PauloSao PauloBrazil

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