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The gastrointestinal tract (GI) is the second most affected organ system in individuals suffering from systemic/localized scleroderma (SSc) or localized scleroderma. SSc can affect any part of the GI, between the oral cavity and anorectum. The annual incidence of SSc in the United States is estimated to be 19.3 cases per million adults, with the highest incidence reported in people aged 44 to 55. Females are 5 times more likely than males to suffer from SSc. Morbidity and mortality rates associated with SSc are predominantly elevated among patients with GI manifestations. Esophageal and intestinal manifestations impact 90% and 40% to 70% of patients with systemic scleroderma, respectively. SSc patients are known to suffer from small bowel hypomotility and small intestinal bacterial overgrowth, which cause malabsorption and malnutrition, ultimately contributing to the 50% mortality rate. Fecal incontinence is a common symptom of SSc that can lead to depression. SSc patients may suffer from gastrointestinal complications that can negatively impact their quality of life on a daily basis. Multidisciplinary approaches are necessary for systematically managing gastrointestinal complications associated with SSc. A prospective study should focus on developing targeted therapies to improve recovery patterns and prognosis in cases of SSc. This article summarizes the epidemiology, commonly reported clinical manifestations, complications, and available treatments for treating GI pathology in SSc patients.
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http://dx.doi.org/10.1097/MD.0000000000031780 | DOI Listing |
Nat Rev Rheumatol
September 2025
Division of Medicine, Royal Free Campus, University College London, London, UK.
Systemic sclerosis (SSc) is an autoimmune disease in which fibrotic, vascular, autoimmune and fibrotic mechanisms synergize to promote disease progression. SSc is associated with high morbidity and mortality, primarily owing to fibrotic tissue remodelling and subsequent organ failure. Despite progress with the approval of novel therapies, mortality remains high; approximately half of the people diagnosed with SSc will succumb to disease.
View Article and Find Full Text PDFCureus
August 2025
Rheumatology, King's College Hospital London, Dubai, ARE.
Systemic sclerosis (SSc) is an autoimmune rheumatic disease marked by excessive extracellular matrix deposition, causing fibrosis, endothelial dysfunction, and microvascular injury. There are two major types of SSc, limited and diffuse. SSc can affect any organ, leading to dysfunction and failure.
View Article and Find Full Text PDFCurr Opin Rheumatol
September 2025
Division of Rheumatology, Department of Internal Medicine.
Purpose Of Review: This review explores the evolving understanding of vascular dysfunction in systemic sclerosis (SSc), from early endothelial injury to clinical manifestations and emerging therapeutic strategies.
Recent Findings: Endothelial cell (EC) injury, senescence, and endothelial-to-mesenchymal transition are central to SSc vasculopathy. Single-cell and spatial omics have revealed distinct EC subtypes and dysregulated pathways, including interferon signaling and chromatin remodeling.
Immunol Invest
September 2025
Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Objective: To examine whether features of the B cell receptor (BCR) IgG repertoire correlate with disease activity and clinical phenotypes in systemic autoimmune diseases (SAIDs).
Methods: High-throughput sequencing was performed on IgG heavy chain repertoires from 138 patients with SAIDs, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), scleroderma (SSc), and idiopathic inflammatory myopathy (IIM), as well as 36 healthy controls (HC). We analyzed V/D/J gene usage, clonal distribution and diversity, CDR3 length distribution and amino acid usage, and the correlation between specific BCR features and clinical features.
Ann Med Surg (Lond)
September 2025
Department of Internal Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Introduction And Importance: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of internal organs and vasculopathy. It commonly involves the skin and multiple organs, including the kidneys and cardiovascular system. Cardiac tamponade in SSc is an uncommon manifestation, often occurring alongside scleroderma renal crisis (SRC).
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