Severe Visceral Damage in Systemic Scleroderma in Abidjan (Ivory Coast)

Objective: Study of severe visceral damage in systemic scleroderma in the rheumatology Department of CHU de Cocody. Patients and Methods: We conducted a retrospective descriptive study of the records of patients hospitalised for systemic scleroderma according to ACR/EULAR 2013 criteria in the rheumatology Department of CHU de Cocody over an 11-year period from January 1, 2005 to December 31, 2016. Results: A total of 18 patients had systemic scleroderma, 10 of whom had severe visceral damage with a frequency of 55.5%. All patients were female. The mean age was 34.5 ± 15.4 years. The mean duration of the disease was 3.5 ± 4.1 years. Clinically, 7 patients (70%) had a dry cough, 5 (50%) had stage dyspnoea and 2 (20%) had palpitations. Serious damage was pulmonary, cardiac and digestive in 8 patients (80%), 4 patients (40%) and 3 patients (30%) respectively. Pulmonary damage was mainly a combination of pulmonary arterial hypertension and interstitial lung disease in 5 patients (62.5%). Cardiac damage was represented by pericarditis in 3 patients (75%). Gastro-oesophageal reflux disease occurred in 2 patients (66.7%). Biologically, anti-nuclear antibodies were positive in all patients, Anti-Scl-70 in 44.4% and anti-centromeres in 22.2%. The course was marked by 3 deaths due to cardiovascular failure. Conclusion: Severe visceral damage is common in systemic scleroderma, dominated by cardiac and pulmonary attacks.