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Pulmonary & renal involvement in scleroderma Dr. Rauf R. Merza ( ASS.PROFESSOR ) Prepared by : Dr. Yahya A. Mohammad
A 44 years old female from Kalar presented with swelling of both hands & feet of one month duration .
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fever with rigor & sweating associated with exertional dyspnea .
Systemic review : G.I.T. :  dysphagia ( difficulty in swallowing solid food eased by drinking water ) , with
Inability to open her mouth widely , heartburn , wt. loss  , & constipation .
C.V.S. :  normal . Resp.S. :  dry cough , exertional dyspnea . G.U.T. :  bilateral loin pain , dysuria , &
frequency . C.N.S. :  normal . M.S.K. :  generalized bodyache & fatigue .
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Gyneocological Hx. : G6 P6 A0 Family Hx. :  -ve Social Hx. :  not smoker or drinker .
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end inspiratory crackles . Abdomen :  soft .no organomegaly .
Skin :  Thickining of skin of hands , forearms , arms , neck , chest , & lower limbs .
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over the palmar surface of hands & flexion contractures of fingers specially little finger .
 
 
 
 
 
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Investigations
 
 
 
 
 
 
 
 
Pulmonary Function Test
restrictive lung dis. (pulm. fibrosis )
CT scan  of chest
 
 
 
 
 
 
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Scleroderma Classification : 1. Diffuse cutaneous SSc. 2. Limitted cut. SSc.
3. Overlap syndrome . 4. Undefined connective tissue dis. 5. Localized scleroderma .
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Scleroderma