Inflammatory stays inflammatory: a subgroup of systemic sclerosis characterized by high morbidity and inflammatory resistance to cyclophosphamide

Elevated levels of C-reactive protein (CRP) in systemic sclerosis (SSc) have been linked to early inflammatory stages of the disease. This study has been designed to investigate CRP levels longitudinally in a cohort of SSc patients and to correlate these findings with comorbidities and disease chara...

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Published in:Arthritis research & therapy 2019-12, Vol.21 (1), p.262-262, Article 262
Main Authors: Mitev, Aleksey, Christ, Lisa, Feldmann, Daria, Binder, Moritz, Möller, Kim, Kanne, Anna-Maria, Hügle, Thomas, Villiger, Peter M, Voll, Reinhard E, Finzel, Stephanie, Kollert, Florian
Format: Article
Language:English
Subjects:
Arthritis
C-reactive protein
Cardiac arrhythmia
Cardiovascular disease
Cyclophosphamide
Hypertension
Inflammation
Intubation
Laboratories
Pathogenesis
Pulmonary arteries
Pulmonary fibrosis
Scleroderma
Systemic sclerosis
Ultrasonic imaging
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Summary:Elevated levels of C-reactive protein (CRP) in systemic sclerosis (SSc) have been linked to early inflammatory stages of the disease. This study has been designed to investigate CRP levels longitudinally in a cohort of SSc patients and to correlate these findings with comorbidities and disease characteristics. In this retrospective study, patients with SSc treated at the outpatient clinic of the Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, were analyzed. Only patients with at least three consecutive visits and at least 1 year follow-up were included in this study. CRP serum levels were measured at every visit and categorized as positive if CRP concentrations were ≥ 5 mg/l. Subjects with elevated CRP levels at more than 80% of visits were defined as inflammatory SSc. The longitudinal CRP profiles were correlated with disease characteristics and comorbidities. A total of 1815 consecutive visits of 131 SSc patients were analyzed. Over the observed time span (7.6 (1.0-19.5) years), 18.3% (n = 24) of patients had continuously elevated CRP levels (inflammatory SSc), whereas in 29% (n = 38), CRP levels were always in the normal range. There was no association between disease duration and CRP levels at first visit. Inflammatory SSc was associated with male gender (p = 0.022), anti-Scl-70 antibodies (p = 0.009), diffuse cutaneous SSc (p = 0.036), pulmonary fibrosis (p 
ISSN:1478-6362
1478-6354
1478-6362
DOI:10.1186/s13075-019-2057-x