Pancreatic necrosis in progressive systemic sclerosis.

Abraham, A A; Joós, A

doi:10.1136/ard.39.4.396

Cited by 13 publications

(4 citation statements)

References 11 publications

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“…However, although usually attributed to SIBO, malabsorption in SSc can also be caused by exocrine pancreatic insufficiency . Case reports of fatal pancreatic infarction and acute haemorrhagic pancreatitis secondary to occlusion of medium‐sized pancreatic arteries in SSc, have been described as well …”

Section: Resultsmentioning

confidence: 99%

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

Kumar

Singh

Rattan

et al. 2017

Aliment Pharmacol Ther

108

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SUMMARY Background Gastrointestinal tract involvement is a common cause of debilitating symptoms in patients with systemic sclerosis. There are no disease modifying therapies for this condition and the treatment remains symptomatic, largely owing to the lack of a clear understanding of its pathogenesis. Aim To investigate novel aspects of the pathogenesis of gastrointestinal involvement in systemic sclerosis To summarize existing knowledge regarding the cardinal clinical gastrointestinal manifestations of systemic sclerosis and its pathogenesis, emphasizing recent investigations that may be valuable in identifying potentially novel therapeutic targets. Methods Electronic (Pubmed/Medline) and manual Google search Results The gastrointestinal tract is the most common internal organ involved in systemic sclerosis. Any part of the gastrointestinal tract from the mouth to the anus can be affected. There is substantial variability in clinical manifestations and disease course and symptoms are non-specific and overlapping for a particular anatomical site. Gastrointestinal involvement can occur in the in the absence of cutaneous disease. Up to 8% of systemic sclerosis patients develop severe gastrointestinal tract symptoms. This subset of patients display increased mortality with only 15% survival at 9 years. Dysmotiity of the gastrointestinal tract causes the majority of symptoms. Recent investigations have identified a novel mechanism in the pathogenesis of gastrointestinal tract dysmotility mediated by functional anti-muscarinic receptor autoantibodies. Conclusion Despite extensive investigation the pathogenesis of gastrointestinal involvement in systemic sclerosis remains elusive. Although treatment currently remains symptomatic, an improved understanding of novel pathogenic mechanisms may allow the development of potentially highly effective approaches including intravenous immunoglobulin and microRNA based therapeutic interventions.

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Section: Resultsmentioning

confidence: 99%

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

Kumar

Singh

Rattan

et al. 2017

Aliment Pharmacol Ther

108

View full text Add to dashboard Cite

show abstract

“…Choledochoscopy, sphincteroplasty, or choledochoduodenostomy did not re¬ sult in an increased incidence of postoperative pancreatitis; however, there was a 35% incidence of hyperamylasemia in patients undergoing sphincteroplasty (Table 4). There were 87 patients undergoing common duct explora¬ tion with preoperative pancreatic dysfunction, including 35 patients with a history of pancreatitis, 23 patients with preoperative hyperamylasemia without pancreatitis, and 29 patients with operatively confirmed pancreatitis (Table 5). Postoperative pancreatitis was present in 17% of these patients, occurring in seven patients with preoperative pancreatitis.…”

Section: Methodsmentioning

confidence: 99%

Pancreatitis After Biliary Tract Surgery

Vernava

Andrus

Herrmann³

et al. 1987

Arch Surg

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“…Cases of pancreatic necrosis, acute hemorrhagic pancreatitis and chronic pancreatitis have been reported in SSc due to involvement of sphincter of Odi leading to stenosis [ 182 , 183 ].…”

Section: Gi Involvement In Sscmentioning

confidence: 99%

Gastrointestinal Manifestations of Systemic Sclerosis

et al. 2018

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Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibroproliferative alterations of the microvasculature leading to fibrosis and loss of function of the skin and internal organs. Gastrointestinal manifestations of SSc are the most commonly encountered complications of the disease affecting nearly 90% of the SSc population. Among these complications, the esophagus and the anorectum are the most commonly affected. However, this devastating disorder does not spare any part of the gastrointestinal tract (GIT), and includes the oral cavity, esophagus, stomach, small and large bowels as well as the liver and pancreas. In this review, we present the current understanding of the pathophysiologic mechanisms of SSc including vasculopathy, endothelial to mesenchymal transformation as well as the autoimmune pathogenetic pathways. We also discuss the clinical presentation and diagnosis of each part of the GIT affected by SSc. Finally, we highlight the latest developments in the management of this disease, addressing the severe malnutrition that affects this vulnerable patient population and ways to assess and improve the nutritional status of the patients.

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Pancreatic necrosis in progressive systemic sclerosis.

Cited by 13 publications

References 11 publications

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

Pancreatitis After Biliary Tract Surgery

Gastrointestinal Manifestations of Systemic Sclerosis

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