Extended reports
Distribution of macrovascular disease in scleroderma
a Department of
Rheumatology, Prince Henry Hospital, Sydney, Australia, b Department of
Rheumatology, Royal North Shore Hospital, Sydney, Australia, c Department of Vascular Surgery, Prince
Henry Hospital, Sydney, Australia
Correspondence to: Dr L Stafford, St Anthonys, St Vincents Hospital, Elm Park, Dublin 4, Ireland.
Accepted for publication 9 June 1998
OBJECTIVE
Macrovascular
disease in scleroderma has recently been described in two comparative
studies. The aim of this study was to map its anatomical distribution.
METHODSIn a
retrospective cohort study of 20 scleroderma patients, the results of
Doppler studies of arteries in the limbs, neck, and abdomen were
compared with those from 20 cohort negative patients. The latter were
matched for age, sex, and the presence/absence of hypertension,
hyperlipidaemia, smoking, and diabetes status. Arteries were
compared quantitatively using a body surface area adjusted measurement
of intraluminal diameter, and qualitatively using descriptive
characteristics of the arterial walls. The latter were binomially
categorised under three non-exclusive headingsthickening, stenosis,
and calcification.
RESULTSThe ulnar
arteries in scleroderma patients were significantly narrower than those
of the negative cohort. The arterial walls were also characterised by
smooth thickening along their entire length. The characteristics of the
other arteries, including those of the lower limbs, were not
significantly different from those of the negative cohort.
CONCLUSIONThe ulnar
artery seems to be specifically targeted in patients with scleroderma.
Assessment of the ulnar artery should be considered in these patients
by means of a modified Allen's test or Doppler sonography especially
in the presence of digital gangrene.
© 1998 by Annals of the Rheumatic Diseases
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