Telangiectasias bleeding in patient with multiple sclerosis

Martínez-Caselles, Alejandro; Martínez-Pascual, Cristina; Martínez, María José Moreno; Sánchez-Torres, Antonio; Carballo-Álvarez, Luis Fernando

doi:10.4321/s1130-01082011000600008

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…In addition, telangiectasia is considered as a risk factor for the presence of PAH in SSc patients (57), and is included in the DETECT nomogram, which was developed to identify SSc patients with high PAH risk (58). Therefore, it is likely that SSc patients with PAH frequently have telangiectasias, and thus have a risk for bleeding from the lesions, although reports on massive hemorrhage from telangiectasia under PAH treatment are scarce (59). Since pulmonary vasodilators are able to improve blood flow in periphery, it is necessary to give care to gastrointestinal bleeding in SSc patients with massive telangiectasia or gastrointestinal vascular ectasia.…”

Section: Discussion Of Casementioning

confidence: 99%

Complex Pathophysiology of Pulmonary Hypertension Associated with Systemic Sclerosis: Potential Unfavorable Effects of Vasodilators

Shirai

Kuwana

2017

Journal of Scleroderma and Related Disorders

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achieved in total PAH population, sub-analysis within CTD-PAH patients showed failure to achieve short-term primary endpoints (2-4). In addition, current PH registries, such as REVEAL and ASPIRE, showed that patients with SSc-PAH had worse prognosis than those with other PH subgroups (5, 6). Recent meta-analysis on prognosis of patients with SSc-PAH reported that 1-, 2-, and 3-year survival rates were 82%, 67%, and 56%, respectively, even in modern treatment era (7). Furthermore, a recent striking report has demonstrated that survival in SSc-PAH had not improved at all after availability of oral pulmonary vasodilators, whereas survival in patients with idiopathic or heritable PAH had improved remarkably (8). Precipitating factors for poor prognosis of SSc-PAH still remain unclear, but at least two mechanisms can be speculated: poor responsiveness to pulmonary vasodilators and potential emergence of unfavorable effects by use of pulmonary vasodilators. The histology of pulmonary vasculature in patients with SSc-PAH is unique and is characterized by concentric intimal fibrosis with less prominent hypertrophy of vascular smooth muscle cells (9), which is a main target of pulmonary vasodilators. On the other hand, pathophysiological conditions of SSc-PAH are highly complex, since SSc affects not only pulmonary arteries, but also other organ systems, including lung interstitium, myocardium, gastrointestinal tract, and peripheral vasculature (10). Therefore, upon introduction of pulmonary vasodilators, it is necessary to consider their potential beneficial or harmful effects on the entire SSc lesions.

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Section: Discussion Of Casementioning

confidence: 99%

Complex Pathophysiology of Pulmonary Hypertension Associated with Systemic Sclerosis: Potential Unfavorable Effects of Vasodilators

Shirai

Kuwana

2017

Journal of Scleroderma and Related Disorders

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Colonic Manifestations and Complications Are Relatively Under-Reported in Systemic Sclerosis: A Systematic Review

et al. 2019

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OBJECTIVES: Although systemic sclerosis (SSc) is known to affect the gastrointestinal (GI) tract, most of the literature focuses on esophageal, small intestinal, or anorectal manifestations. There have been no reviews focused on large bowel SSc complications in over 30 years. The aim of this study is to perform a systematic review of colonic manifestations and complications of SSc. METHODS: An experienced librarian conducted a search of databases, including English and Spanish articles. The search used keywords including “systemic sclerosis,” “scleroderma,” and “colon.” A systematic review was performed using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Case reports/series were screened for validity by adapting from criteria published elsewhere. RESULTS: Of 1,890 articles, 74 met selection criteria. Fifty-nine of the 77 articles were case reports/series. The most common article topics on colonic SSc complications were constipation/dysmotility (15), colonic volvulus (8), inflammatory bowel disease (7), microscopic colitis (6), megacolon (6), and telangiectasia (6). Colonic manifestations constituted 24% of articles on GI complications of SSc. There were a total of 85 cases (84% women, with a median age of onset of colon complication of 52 years). Limited cutaneous SSc phenotype (65.6%) was more common than diffuse (26.2%). Patients frequently had poor outcomes with high mortality related to colonic complications (27%). Recent studies explore contemporary topics such as the microbiome in SSc and prucalopride for chronic constipation in SSc. DISCUSSION: Colonic complications comprise a large proportion of the published reports on GI symptoms afflicting patients with SSc and require raised diagnostic suspicion and deliberate action to avoid potentially serious complications including death.

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Telangiectasias bleeding in patient with multiple sclerosis

Cited by 2 publications

References 3 publications

Complex Pathophysiology of Pulmonary Hypertension Associated with Systemic Sclerosis: Potential Unfavorable Effects of Vasodilators

Complex Pathophysiology of Pulmonary Hypertension Associated with Systemic Sclerosis: Potential Unfavorable Effects of Vasodilators

Colonic Manifestations and Complications Are Relatively Under-Reported in Systemic Sclerosis: A Systematic Review

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