Mortality and risk factors of scleroderma renal crisis: a French retrospective study of 50 patients

Teixeira, Luciana Barcellos; Mouthon, Luc; Mahr, Alfred; Bérezné, Alice; Agard, C.; Mehrenberger, Marion; Lh, Noël; Trolliet, Pierre; Françès, Camille; Cabané, J.; Guillevin, Loı̈c

doi:10.1136/ard.2006.066985

Cited by 210 publications

(193 citation statements)

References 21 publications

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“…Corticosteroids are used with caution in patients with SSc because they have been associated with an increased risk of scleroderma renal crisis (40). When required, particularly in the presence of joint and/or inflammatory muscle involvement, corticosteroids should be prescribed at a low dosage (e.g., prednisone Ͻ15 mg/day) (20).…”

Section: Resultsmentioning

confidence: 99%

Recommendations for the care of oral involvement in patients with systemic sclerosis

Alantar¹,

Cabané²,

Hachulla³

et al. 2011

Arthritis Care & Research

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Objective. To review the literature and collect expert advice for proposing preventive and curative treatments of mouth and dental involvement in patients with systemic sclerosis (SSc; scleroderma). Methods. The literature pertaining to mouth and/or dental involvement related to SSc was reviewed, and recommendations were developed according to the suggestions of a French multidisciplinary working group of experts and validated by a lecture committee. Results. Dentists face 3 main issues in caring for SSc patients: oral mucosa involvement, manducatory apparatus and mouth involvement responsible for limitations in mouth opening, and treatment-related adverse events. An increased risk of tongue carcinoma has been noted. In patients with severe limitation in mouth opening (<30 mm), recommended treatments are a specific mouth-opening rehabilitation program, flexible sectional dentures, and splint therapy. Indications for dental implants depend on the severity of SSc, comorbidities, and/or ongoing bisphosphonate treatment. Prevention of mouth infections and caries implies patient education and teaching about mouth and dental hygiene, periodontal maintenance, and treatment of sicca syndrome. Cessation of tobacco use is mandatory. Patient-tailored rehabilitation may improve limitations in mouth opening. Systematic dental panoramic radiography allows for the early detection of dental caries. Conclusion. Prevention of oral and dental complications is a major issue in patients with SSc. Dental treatment should be tailored to limitations in mouth opening, disease severity, and ongoing treatments.

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Section: Resultsmentioning

confidence: 99%

Recommendations for the care of oral involvement in patients with systemic sclerosis

Alantar¹,

Cabané²,

Hachulla³

et al. 2011

Arthritis Care & Research

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“…Approximately 2-5 % of patients with scleroderma suffer from 'renal crisis' , which is characterised by severe hypertension, rapidly progressive glomerulonephritis and crescent glomerulonephritis [26] with a decline in the renal function and thrombotic microangiopathy; this condition shows a significant benefit from early angiotensin-converting-enzyme inhibitor therapy and strict blood pressure control [27]. Renal crisis constitutes a rare and dangerous complication, and the affected patients present with prominent left heart failure and hypertensive encephalopathy [28]. Renal failure could be associated with moderate proteinuria without haematuria.…”

Section: Connective Tissue Diseases and Sclerodermamentioning

confidence: 99%

Hypertensive Emergencies: a New Clinical Approach

Lagi

Cencetti

2014

J Hypertens

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The expression 'hypertensive urgencies' includes many diseases. The unifying features of these diseases are a high level of arterial pressure and acute distress of one or more organs. The aim of the review was to define the idea of the 'acute hypertension' as a new concept, different from 'chronic hypertension'. Acute hypertension might be related to 'organ damage' because it is the cause, the consequence or an effect of the acute stress. We compounded a narrative review which has included analyses of 373 articles. The structure of the search strategy included a literature search of PubMed, MEDLINE, Cochrane Library and Google Scholar databases. We applied the following inclusion criteria: prospective double-blind randomised controlled trials, experimental animal work studies, case-control studies and recruiting patients representative of the general sick population. In this review, the diseases included in the term 'hypertensive emergencies' share 'acute' hypertension. This is a new idea that emphasises the suddenly increased arterial pressure, irrespective of the initial arterial pressure and independent of the goals of hypertension control. The 'hypertensive emergencies' have been grouped together in three subsets: (1) diseases that result from acute hypertension that is caused by faulty regulation of the peripheral circulation (acute primary hypertension), (2) diseases that produce hypertension (acute secondary hypertension) and 3) diseases that have hypertension as an effect of the acute stress caused by the principle disease (acute associated hypertension). This review highlights a novel idea: acute hypertension is a common sign of different diseases characterised by the sudden surge of arterial pressure, so overwhelming the difference between hypertensive emergencies and urgencies. The judgment of acute hypertension is independent of the initial arterial pressure, normotension or hypertension and is linked with the transient failure of the baroreflex. Hypertensive emergencies are grouped together because all of these diseases require prompt therapy to prevent the negative outcomes of acute hypertension

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“…The pattern of ANA immunofluorescence is usually speckled (Penn, et al, 2007). Anti-centromere antibody, which is typically observed in lcSSc, has been infrequently reported in SRC patients Steen, 2005;Teixeira et al, 2008). Some investigators even consider the detection of anti-centromere antibody to be protective against renal crises (Penn, et al, 2007).…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

“…Compared to other autoimmune connective tissue diseases, SRC has the worst prognosis (Ferri, et al, 2002;LeRoy et al, 1988). Predictors of poor outcome in SRC include male gender, age above fifty years, cardiac disease and dcSSc with extensive skin sclerosis (higher skin score) (Denton, Lapadula, Mouthon, & Muller-Ladner, 2009;Teixeira, et al, 2008). Normal blood pressure at presentation has also been associated with a poor prognosis (Medsger, Masi, Rodnan, Benedek, & Robinson, 1971;Penn, et al, 2007;Teixeira, et al, 2008).…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

“…Predictors of poor outcome in SRC include male gender, age above fifty years, cardiac disease and dcSSc with extensive skin sclerosis (higher skin score) (Denton, Lapadula, Mouthon, & Muller-Ladner, 2009;Teixeira, et al, 2008). Normal blood pressure at presentation has also been associated with a poor prognosis (Medsger, Masi, Rodnan, Benedek, & Robinson, 1971;Penn, et al, 2007;Teixeira, et al, 2008). Patients with normotensive SRC could possibly have lower activation of their renin-angiotensin system and therefore a lower blood pressure at presentation (Penn, et al, 2007).…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

See 1 more Smart Citation

Scleroderma Renal Crisis

Chabtini¹,

Mounayar²,

Azzi³

et al. 2012

Systemic Sclerosis - An Update on the Aberrant Immune System and Clinical Features

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Mortality and risk factors of scleroderma renal crisis: a French retrospective study of 50 patients

Abstract: SRC remains associated with severe morbidity and mortality. CS might increase the risk of developing SRC. Further studies are needed to confirm these results.

Cited by 210 publications

References 21 publications

Recommendations for the care of oral involvement in patients with systemic sclerosis

Recommendations for the care of oral involvement in patients with systemic sclerosis

Hypertensive Emergencies: a New Clinical Approach

Scleroderma Renal Crisis

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