Abstract
Although digital ulceration frequently occurs in patients with systemic sclerosis, there have been few reports on macrovascular involvement. Macrovascular disease in systemic sclerosis has recently been described. We retrospectively reviewed the medical records and brachial angiographic findings of 19 systemic sclerosis patients, who exhibited Raynaud’s phenomenon and digital ulceration. We found that ulnar artery involvement is frequent in systemic sclerosis, although the precise mechanism is not known. There was no significant difference in risk factors of macrovascular disease between ulnar artery-involved patients and not-involved subjects. Thirteen patients underwent surgical intervention; five of the 13 patients had vascular graft performed due to ulnar artery involvement. We suggest that angiographic screening and early surgical intervention such as revascularization should be considered in patients with systemic sclerosis who manifest a severe form of Raynaud’s phenomenon and/or digital ulceration and especially in patients with diffuse sclerosis.
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References
Lau CS, McLaren M, Belch JJ (1991) Factor VIII von Willebrand factor antigen levels correlate with symptom severity in patients with Raynaud’s phenomenon. Br J Rheumatol 30:433–436. doi:10.1093/rheumatology/30.6.433
Walmsley D, Goodfield MJ (1990) Evidence for an abnormal peripherally mediated vascular response to temperature in Raynaud’s phenomenon. Br J Rheumatol 29:181–184. doi:10.1093/rheumatology/29.3.181
Kahaleh MB (1994) Raynaud’s phenomenon and vascular disease in scleroderma. Curr Opin Rheumatol 6:621–627. doi:10.1097/00002281-199411000-00013
Hasegawa M, Nagai Y, Tamura A, Ishikawa O (2006) Arteriographic evaluation of vascular changes of the extremities in patients with systemic sclerosis. Br J Dermatol 155:1159–1164. doi:10.1111/j.1365-2133.2006.07475.x
Taylor MH, McFadden JA, Bolster MB, Silver RM (2002) Ulnar artery involvement in systemic sclerosis (scleroderma). J Rheumatol 29:102–106
Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic, Therapeutic Criteria Committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590
Youssef P, Englert H, Bertouch J (1993) Large vessel occlusive disease associated with CREST syndrome and scleroderma. Ann Rheum Dis 52:464–466
Youssef P, Brama T, Englert H, Bertouch J (1995) Limited scleroderma is associated with increased prevalence of macrovascular disease. J Rheumatol 22:469–472
Veale DJ, Collidge TA, Belch JJ (1995) Increased prevalence of symptomatic macrovascular disease in systemic sclerosis. Ann Rheum Dis 54:853–855
Stafford L, Englert H, Gover J, Bertouch J (1998) Distribution of macrovascular disease in scleroderma. Ann Rheum Dis 57:476–479
Ho M, Veale D, Eastmond C, Nuki G, Belch J (2000) Macrovascular disease and systemic sclerosis. Ann Rheum Dis 59:39–43. doi:10.1136/ard.59.1.39
Stucker M, Quinna S, Memmel U, Rochling A, Traupe M, Hoffmann K et al (2000) Macroangiopathy of the upper extremities in progressive systemic sclerosis. Eur J Med Res 5:295–302
Kaji H, Honma H, Usui M, Yasuno Y, Saito K (1993) Hypothenar hammer syndrome in workers occupationally exposed to vibrating tools. J Hand Surg [Br] 18:761–766. doi:10.1016/0266-7681(93)90240-G
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Park, J.H., Sung, YK., Bae, SC. et al. Ulnar artery vasculopathy in systemic sclerosis. Rheumatol Int 29, 1081–1086 (2009). https://doi.org/10.1007/s00296-009-0906-7
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DOI: https://doi.org/10.1007/s00296-009-0906-7