[Symptoms from the internal organs of patients with systemic sclerosis in the light of selected diagnostic tests]. / Dolegliwosci ze strony narzadów wewnetrznych chorych na twardzine ukladowa w swietle wybranych badan diagnostycznych.

ABSTRACT

UNLABELLED Systemic sclerosis (SSc) is a chronic, progressive connective tissue disease with the different clinical course characterized by a progressive fibrosis of the skin and internal organs, leading to their failure, changes in blood morphology and blood vessels disorders. The disease most often affects the skin, the osteoarticular system, the alimentary tract, the cardio-vascular system, lungs, kidneys and the nervous system. In involved systems and organs observed symptoms are able to develop gradually relatively to disease course, leading to a permanent and irreversible health damage. The aim of study was to identify major symptoms of SSc patients and to examine the relation between patients' complaints and the results of diagnostic tests pulmonary artery pressure (PHT), lung image (X-ray and HRCT) and cytology of broncho-alveolar lavage (BAL), oesophagus X-ray and stress ECG. MATERIAL AND METHODS: The study group consisted of 63 patients with diagnosed SSc according to the ARA criteria 47 with limited systemic sclerosis (ISSc) (74.6%) and 16 with diffuse systemic sclerosis (dSSc) (25.4%). The basic research tool was a survey questionnaire drafted for the needs of this study, assessing the health problems of patients. The examination was performed in all patients and the results of diagnostic tests were completed in selected groups according to therapeutic purposes. RESULTS: From the all identified symptoms from the alimentary tract the most characteristic was heartburn (in 71% cases). About 60% of subjects reported difficulties with swallowing, out of which 68% were ISSc patients (p < or = 0.05). The X-ray examination of the oesophagus showed a shallow peristaltic wave in 55% patients with this complaint, and it occurred significantly more often in patients who were diagnosed as ISSc for > or = 15 years (p < or = 0.05). A positive result of HRCT was more often obtained in the group of patients with dSSc (p < or = 0.05). It has been proved that there is a significant relation between fatigue reported by patients and a positive result of HRCT and BAL (p < or = 0.05). A positive result of exercise ECG was obtained in 69% of patients with dyspnoea and 61% with fatigue (p < or = 0.05). CONCLUSIONS: Disorders of the gastrointestinal tract demonstrated particular intensity in patients with ISSc, with known shall owing of the peristaltic wave in the X-ray of the esophagus. Pulmonary changes were observed in HRCT and BAL, concerned mostly dSSc patients in whom fatigue was the major symptom. Patients who declared fatigue and dyspnoea had changes in exercise ECG, with no relation to the clinical presentation of SSc.