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Evaluation of hypertension in systemic sclerosis and systemic lupus erythematosus overlap

Erin Chew1, April Barnado1, Talat Alp Ikizler2,3

  • 1Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

Journal of Scleroderma and Related Disorders
|February 6, 2023
PubMed

Insights

Diagnosing and managing hypertension in patients with overlapping systemic sclerosis and systemic lupus erythematosus requires careful consideration of treatment differences. Advanced imaging techniques can help assess long-term vasculopathy progression in these complex cases.

Area of Science:

  • Rheumatology
  • Nephrology
  • Cardiology

Background:

  • Hypertension in patients with overlapping systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) presents unique clinical challenges.
  • Treatment strategies for non-renal crisis hypertension differ significantly between SSc and SLE.
  • Early and accurate diagnosis is crucial for effective management.

Purpose of the Study:

  • To discuss the diagnostic approach for patients with SSc and SLE overlap who present with hypertension.
  • To highlight the importance of differentiating management strategies based on underlying autoimmune serologies.
  • To explore the role of advanced imaging in assessing long-term vasculopathy.

Main Methods:

  • Review of current literature on hypertension management in SSc and SLE overlap.
  • Discussion of diagnostic criteria and urgent laboratory studies.
  • Evaluation of imaging modalities for assessing vasculopathy.

Main Results:

  • Urgent laboratory studies and, in symptomatic cases, imaging are indicated for SSc-SLE overlap patients with hypertension.
  • Non-contrast imaging advances offer potential biomarkers for progressive vasculopathy.
  • Distinct treatment choices exist for non-renal crisis hypertension in SSc versus SLE.

Conclusions:

  • A tailored diagnostic and management approach is essential for hypertensive patients with SSc-SLE overlap.
  • Long-term monitoring using advanced imaging can improve assessment of vasculopathy.
  • Understanding the nuances between SSc and SLE is critical for optimal patient outcomes.

Keywords:
Systemic sclerosishypertensionrenal crisissystemic lupus erythematosus

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