OSTEOPOROSIS IN SYSTEMIC SCLEROSIS

Background. Osteoporosis (OP) and fragility fractures are common and well-known comorbidities in patients with rheumatic diseases. However, the prevalence and risk factors for OP in systemic sclerosis (SSc) are not well understood. According to the literature, the incidence of OP in SSc ranges from 8.8% to 51.6%. Predictors of bone loss in systemic sclerosis have not been definitively established. Aim. This study presents the clinical case of osteoporosis in patients with systemic sclerosis and provides comprehensive data on the prevalence and associated risk factors for bone loss in this disease. Materials and methods. This article describes the clinical case of OP in patients with SSc and reviews the literature using PubMed, Medline, and the Cochrane Library with keywords such as bone mineral density, osteoporosis, prevalence, risk factors, and systemic sclerosis. Results. We demonstrate the clinical case of OP in a patient with SSc and the prompt positive effect of bisphosphonate treatment. The patient’s additional risk factors for bone loss associated with SSc were diffuse cutaneous SSc subtype, sclerodactily with active digital ulcers, late scleroderma pattern on capillaroscopy, ILD, gastrointestinal involvement, and treatment with PPI. Conclusion. OP is rather prevalent in patients with SSc. According to published data, specific disease-related factors associated with OP are: disease duration, digital ulcers, calcinosis, pulmonary and gastrointestinal involvement as treatments with PPI and GCs. These findings support the identifying SSc patients at a higher risk for OP in clinical practice and its complications.