Limited Scleroderma-Induced Pulmonary Arterial Hypertension Resulting in Impaired Postoperative Respiratory Function

Area of Science:

• Internal Medicine
• Rheumatology
• Cardiology

Background:

• Limited scleroderma is a subtype of systemic sclerosis, an autoimmune condition.
• Systemic sclerosis can lead to multiorgan dysfunction, including pulmonary arterial hypertension.
• Pulmonary arterial hypertension (PAH) is a serious complication that can affect patients with scleroderma.

Observation:

• A case of PAH in an elderly, nonsmoking patient with limited scleroderma is presented.
• The patient experienced abdominal tenderness, diagnosed as a sigmoid colonic stricture, requiring laparoscopic bowel resection.
• Postoperatively, the patient developed worsening respiratory function and a significant pleural effusion.

Findings:

• The patient's respiratory decompensation and pleural effusion necessitated thoracentesis and a prolonged hospital stay.
• This case illustrates the potential for acute, multi-organ system involvement in scleroderma, affecting the colon and lungs.
• Scleroderma patients are susceptible to acute gastrointestinal and pulmonary complications.

Implications:

• Prompt diagnosis and comprehensive management are vital for scleroderma patients.
• Continuous monitoring and vigilance are essential to prevent complications, particularly in the postoperative period.
• This case underscores the need for a multidisciplinary approach in managing complex scleroderma cases.