Summary
Forty-three female patients with systemic sclerosis divided into subgroups based on the extent of skin involvement and the presence of calcinosis, and 50 sex and age-matched healthy controls were investigated for bone mineral density (BMD) on the basis of radial (dual photon absorptiometry, Osteograph, NIM), lumbar, and total body measurements (dual energy X-ray absorptiometry, Lunar DPX, Lunar Corp.), and for parameters of calcium metabolism. The patients showed a lower BMD (mean±SD; mg/cm2) than the controls at the radial (313±69 vs 347±73; p<0.005), lumbar (974±143 vs 1081±154; p<0.005), and total body (997±82 vs 1075±109; p<0.05) determinations. The patients with the diffuse form of skin involvement had lower values than those with the limited form. There was a negative correlation between BMD and the duration of the disease. The presence of calcinosis was not found to have any effect on BMD. Calcium metabolism was found to be normal in each subgroup.
It may be concluded that generalized osteoporosis is a feature of systemic sclerosis, with and without calcinosis. The extent and duration of the disease may play a role in determining bone loss.
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Medsger, T.A.Jr. Systemic sclerosis (scleroderma), localized scleroderma, eosinophilic fasciitis, and calcinosis. In: Arthritis and Allied Conditions. 11th ed. Ed.: D.J. McCarty. Philadelphia, Lea & Febiger, 1989, 1118–1165.
Blocka, K.L.N., Basset, L.W., Furst, D.E., et al. The arthropathy of advanced progressive systemic sclerosis: a radiographic survey. Arthritis Rheum 1981, 24, 874–884.
Serup, J., Hagdrup, H.K., Tvedegaard, E. Bone mineral content in systemic sclerosis measured by photon absorptiometry. Acta Dermatovener 1983, 63, 235–237.
La Montagna, G., Vatti, M., Valentini, G., Tirri, G. Osteopenia in systemic sclerosis. Evidence of a participating role of earlier menopause. Clin Rheumatol 1991, 10, 18–22.
Thibierge, G., Weissenbach, R.J. Concrétion calcaires souscutanées et sclérodermie. Ann Dermatol Syph 1911, 2, 129–155.
Serup, J., Hadgrup, H.K. Parathyroid hormone and calcium metabolism in generalized scleroderma. Arch Dermatol Res 1984, 276, 91–95.
Masi, A.T., Rodnan, G.P., Medsger, T.A.Jr., et al. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 1980, 23, 581–590.
Ferri, C., Bernini, L., Cecchetti, R., et al. Cutaneous and serologic subsets of systemic sclerosis. J Rheumatol 1991, 18, 1826–1832.
Masi, A.T. Classification of systemic sclerosis (scleroderma): relationship of cutaneous subgroups in early disease to outcome and serological reactivity. J Rheumatol 1988, 15, 894–898.
Rodnan, G.P., Jablonska, S., Medsger, T.A. Classification and nomenclature of progressive systemic sclerosis (scleroderma). Clin Rheum Dis 1979, 5, 5–11.
Barnett, A.F. Scleroderma (progressive systemic sclerosis): progress and course based on a personal series of 118 cases. Med J Aust 1978, 2, 129–134.
Le Roy, E.C., Black, C., Fleischmajer, R., et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 1988, 15, 202–205.
Giordano, M., Valentini, G., Migliaresi, S. et al. Different antibody pattern and different prognoses in patients with scleroderma with various extent of skin sclerosis. J Rheumatol 1986, 13, 911–916.
Serup, J., Hagdrup, H.K., Age at menopause of females with systemic sclerosis. Acta Dermatovener 1982, 63, 71–73.
Liel, Y., Edwards, J., Shary, J. et al. The effects of race and body habitus on bone mineral density of the radius, hip and spine in premenopausal women. J Clin Endocrinol Metab 1988, 66, 1247–1250.
De Simone, D.P., Stevens, J., Edwards, J., et al. Influence of body habitus and race on bone mineral density of the midradius, hip and spine in aging women. J Bone Miner Res 1989, 6, 827–830.
Hansen, M.A., Hassager, C., Overgaard, K., Marslew, U., Riis, B.J., Christiansen, C. Dual-energy X-ray absorptiometry: a precise method of measuring bone mineral density in the lumbar spine. J Nucl Med 1990, 31, 1156–1162.
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Di Munno, O., Mazzantini, M., Massei, P. et al. Reduced bone mass and normal calcium metabolism in systemic sclerosis with and without calcinosis. Clin Rheumatol 14, 407–412 (1995). https://doi.org/10.1007/BF02207673
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DOI: https://doi.org/10.1007/BF02207673