[2009] [SAT0231] EARLY ENDOSCOPY IN SYSTEMIC SCLEROSIS PATIENTS WITHOUT GASTROINTESTINAL SYMPTOMS: A RETROSPECTIVE ANALYSE
R. Thonhofer1, C. Siegel1, M. Trummer1, W. Graninger2 1Dept. of Internal Medicine, State Hospital Muerzzuschlag, Muerzzuschlag; 2Division of Rheumatology, Dept. of Internal Medicine, Medical University Graz, Graz, Austria
Background: Gastrointestinal (GI) complications are well documented in systemic sclerosis (SSc) and associated with relevant morbidity. Early diagnosis and therapy of complications especially in the upper GI-tract might be important, since clinical symptoms of GI involvement most of the time are already features of advanced disease.
Objectives: Investigation of the upper GI-tract of patients suffering from SSc without symptoms of GI-tract involvement early in the course of the disease to diagnose inflammatory or motility disorders.
Methods: We retrospectively analysed patients suffering from SSc who underwent oesophago-gastro-duodenoscopy (OGD) within a year of the first diagnosis and without having GI complaints. Patients with a Rodnan skin score above 5, proton-pump-inhibitors and treatment regimes potentially harmful to the mucosa of the upper GI-tract were excluded. Mucosal damage of the oesophagus was classified according to the Los Angeles Classification. Oesophageal dysmotility also was assessed during OGD and confirmed by video cineradiography.
Results: A total of thirteen consecutive patients with SSc and a mean Rodnan score of 3.2 fulfilled the inclusion criteria. OGD revealed reflux-oesophagitis in 77%, dysmotility of the distal oesophagus in 85%, gastritis in 92% (31% erosive gastritis) and helicobacter pylori positivity in 38% of our patients suffering from SSc.
Conclusion: None of the examined patients had reported any GI complaints. However in all thirteen SSc patients significant pathology of the upper GI-tract was found. The results of this study might indicate that OGD should be performed early in patients diagnosed with SSc, even if they do not report typical symptoms. Early treatment of GI involvement might improve the prognosis.
Disclosure of Interest: None declared
Ann Rheum Dis 2009;68(Suppl3):617
Scleroderma, myositis and related syndromes
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