Clinical features of systemic sclerosis

This descriptive study was carried out to determine the clinical and epidemiological pattern of systemic sclerosis in Iraqi patients who prove to have the disease.

Between March 1997 and December 1999, 75 patients, 67 females and 8 males, were studied at 2 teaching hospitals in Baghdad, Iraq. The diagnosis of the disease was based on clinical findings, biochemical, serological, and pulmonary function tests.

All the patients had Raynaud's phenomenon, 72 (96%) had arthralgia, 65 (87%) had dysphagia, 62 (83%) had atrophic changes or hypo/hyperpigmentation, 43 (58%) had telangiectasia, and 3 (4%) had subcutaneous calcification. Of the patients studied, 2 patients (3%) had hypertension, one had severe hypertension. Twenty-three patients (31%) had anemia, 58 (77%) had elevated erythrocyte sedimentation rate and 7 patients (9%) with renal impairment. Rheumatoid factor was positive in 17 patients (23%) and antinuclear antibody in 50 (67%). Abnormal chest x-ray was reported in 50 patients (67%). Pulmonary function tests showed restrictive pattern in 53 (71%) patients and obstructive pattern in 3 (4%). Electrocardiogram changes were seen in 3 (4%) of the patients. Three juvenile cases were reported, and familial tendency was noted in one patient. The results were compared with other studies and there were interesting differences and similarities.

Systemic sclerosis is a rare disease in Iraq, nevertheless sporadic cases at a peak age of 20-40 years were reported. Generally the clinical picture was comparable to other studies, however Raynaud's phenomenon is more prevalent in our patients and antinuclear antibody is less common.