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Assessment of calcinosis in Portuguese patients with systemic sclerosis: a multicenter study

2023Journal article Restricted access
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dc.contributor.authorSamões, Beatriz
dc.contributor.authorGuimarães da Fonseca, Diogo
dc.contributor.authorBeirão, Tiago
dc.contributor.authorCosta, Flávio
dc.contributor.authorVieira, Romana
dc.contributor.authorTerroso, Georgina
dc.contributor.authorFerreira, Raquel Miriam
dc.contributor.authorNicolau, Rafaela
dc.contributor.authorSaraiva, André
dc.contributor.authorSalvador, Maria João
dc.contributor.authorDuarte, Ana Catarina
dc.contributor.authorCordeiro, Ana
dc.contributor.authorVilas-Boas, João Paulo
dc.contributor.authorGenrinho, Inês
dc.contributor.authorBento da Silva, Ana
dc.contributor.authorGago, Laura
dc.contributor.authorResende, Catarina
dc.contributor.authorMartins, Patrícia
dc.contributor.authorMadeira, Nathalie
dc.contributor.authorDinis, Sara
dc.contributor.authorCouto, Maura
dc.contributor.authorSantos, Inês
dc.contributor.authorAraújo, Filipe
dc.contributor.authorMourão, Ana Filipa
dc.contributor.authorGomes Guerra, Miguel
dc.contributor.authorOliveira, Margarida
dc.contributor.authorDaniel, Alexandra
dc.contributor.authorRodrigues, Marília
dc.contributor.authorDantas Soares, Catarina
dc.contributor.authorParente, Hugo
dc.contributor.authorFurtado, Carolina
dc.contributor.authorFontes, Tomás
dc.contributor.authorAbelha-Aleixo, Joana
dc.date.accessioned2023-07-18T13:17:44Z
dc.date.available2023-07-18T13:17:44Z
dc.date.issued2023
dc.description© The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2023pt_PT
dc.description.abstractIntroduction/objectives: The study aims to define the clinical and subclinical calcinosis prevalence, the sensitivity of radiographed site and clinical method for its diagnosis, and the phenotype of Portuguese systemic sclerosis (SSc) patients with calcinosis. Method: A cross-sectional multicenter study was conducted with SSc patients fulfilling Leroy/Medsger 2001 or ACR/EULAR 2013 classification criteria, registered in the Reuma.pt. Calcinosis was assessed through clinical examination and radiographs of hands, elbows, knees, and feet. Independent parametric or non-parametric tests, multivariate logistic regression, and sensitivity calculation of radiographed site and clinical method for calcinosis detection were performed. Results: We included 226 patients. Clinical calcinosis was described in 63 (28.1%) and radiological calcinosis in 91 (40.3%) patients, of which 37 (40.7%) were subclinical. The most sensitive location to detect calcinosis was the hand (74.7%). Sensitivity of the clinical method was 58.2%. Calcinosis patients were more often female (p = 0.008) and older (p < 0.001) and had more frequently longer disease duration (p < 0.001), limited SSc (p = 0.017), telangiectasia (p = 0.039), digital ulcers (p = 0.001), esophageal (p < 0.001) and intestinal (p = 0.003) involvements, osteoporosis (p = 0.028), and late capillaroscopic pattern (p < 0.001). In multivariate analysis, digital ulcers (OR 2.63, 95% CI 1.02-6.78, p = 0.045) predicted overall calcinosis, esophageal involvement (OR 3.52, 95% CI 1.28-9.67, p = 0.015) and osteoporosis (OR 4.1, 95% CI 1.2-14.2, p = 0.027) predicted hand calcinosis, and late capillaroscopic pattern (OR 7.6, 95% CI 1.7-34.9, p = 0.009) predicted knee calcinosis. Anti-nuclear antibody positivity was associated with less knee calcinosis (OR 0.021, 95% CI 0.001-0477, p = 0.015). Conclusions: Subclinical calcinosis high prevalence suggests that calcinosis is underdiagnosed and radiographic screening might be relevant. Multifactorial pathogenesis may explain calcinosis predictors' variability. Key Points • Prevalence of subclinical calcinosis in SSc patients is substantial. • Hand radiographs are more sensitive to detect calcinosis than other locations or clinical method. • Digital ulcers were associated with overall calcinosis, esophageal involvement and osteoporosis were associated with hand calcinosis, and late sclerodermic pattern in nailfold capillaroscopy was associated with knee calcinosis. • Anti-nuclear antibody positivity may be a protective factor for knee calcinosis.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClinical Rheumatology, vol. 42, pages 2125–2134 (2023)pt_PT
dc.identifier.doi10.1007/s10067-023-06617-5pt_PT
dc.identifier.eissn1434-9949
dc.identifier.issn0770-3198
dc.identifier.urihttp://hdl.handle.net/10451/58659
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://www.springer.com/journal/10067pt_PT
dc.subjectCalcinosispt_PT
dc.subjectRadiographypt_PT
dc.subjectSubclinicalpt_PT
dc.subjectSystemic sclerosispt_PT
dc.titleAssessment of calcinosis in Portuguese patients with systemic sclerosis: a multicenter studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleClinical Rheumatologypt_PT
person.familyNameMartins
person.givenNamePatrícia
person.identifier.orcid0000-0003-3578-7213
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication28ce5691-575c-4bf4-9428-58ce9acefef7
relation.isAuthorOfPublication.latestForDiscovery28ce5691-575c-4bf4-9428-58ce9acefef7

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