Scleroderma 

Diagnosis  

Scleroderma can be challenging to diagnose since it affects so many different body parts and can manifest in so many different ways.  

Your doctor may recommend blood testing to check for high levels of specific antibodies produced by the immune system following a complete physical examination.  

To assist identify whether your digestive system, heart, lungs, kidneys, or other organs are impacted, your doctor may also recommend additional blood testing, imaging, or organ–function tests.  

• Blood tests: 95% of people with scleroderma have elevated levels of immunological factors called antinuclear antibodies. Testing for these antibodies in suspected scleroderma patients can aid with an accurate diagnosis even if they are also found in other autoimmune disorders like lupus.  
• Pulmonary function tests: To assess lung function and determine if scleroderma has affected the lungs, several tests are performed. These tests aim to measure the respiratory capacity and detect any signs of pulmonary involvement, which can lead to the formation of scar tissue. In order to confirm or suspect the presence of scleroderma, medical professionals often utilize X–rays or computed tomography (CT scan) to examine potential lung damage caused by the condition.  
• Electrocardiogram: Scleroderma has the potential to cause fibrosis or scarring of the heart tissue, which can result in complications such as congestive heart failure and abnormal electrical activity in the heart. To determine if the disease has affected the heart, a specific test is conducted. This test aims to assess the condition of the heart and identify any potential cardiac involvement caused by scleroderma.   
• Echocardiogram: To check for problems including pulmonary hypertension and/or congestive heart failure, this is advised once every 6 to 12 months.  
• Gastrointestinal tests: Scleroderma has the potential to impact both the muscular function of the esophagus and the intestinal walls. Consequently, individuals may experience symptoms such as heartburn, difficulty swallowing, impaired nutrient absorption, and disrupted movement of food through the intestine. To assess these conditions, medical professionals may employ an endoscopy, a procedure involving the insertion of a small tube equipped with a camera to examine the esophagus and intestines. Additionally, manometry, a test to gauge the strength of the esophageal muscles, can be conducted. 
• Kidney function: When scleroderma impacts the kidneys, it can lead to elevated blood pressure and protein leakage into the urine. In more severe cases, known as scleroderma renal crisis, there can be a sudden and significant rise in blood pressure, potentially leading to kidney failure. The evaluation of kidney function typically involves blood tests. 

Treatment  

While there is currently no known cure or treatment that can completely halt or reverse the excessive production of collagen associated with scleroderma, there are several treatment options available to manage symptoms and minimize complications. 

 Medications  

The selection of treatment will change depending on the symptoms of scleroderma because it can impact so many various sections of the body. Examples consist of medications that:  

• Dilate blood vessels. Raynaud’s phenomenon may be treated with blood vessel–dilating blood pressure medicines.  
• Suppress the immune system. Some scleroderma symptoms, such skin thickening or worsening lung damage, may be slowed down by immune–suppressing medications, such as those prescribed after organ transplants.  
• Reduce digestive symptoms. Heartburn relief medications can ease the condition. Bloating, diarrhea, and constipation may be lessened by antibiotics and drugs that facilitate the movement of food through the intestines.  
• Prevent infections. Fingertip ulcers brought on by Raynaud’s illness may be prevented from getting infected by cleaning them and protecting them from the cold. Regular immunizations against the flu and pneumonia can aid in protecting lungs that have already suffered damage from scleroderma.  
• Relieve pain. Your doctor may recommend prescription painkillers if over–the–counter analgesics are ineffective.  

Therapies  

You can preserve your independence with daily duties while increasing your strength and mobility with the aid of physical or occupational therapy. Hand treatment might help avoid contractures of the hands.  

Surgery and other procedures  

When more conventional treatments have failed to relieve severe symptoms, stem cell transplants may be a possibility. Organ transplants may be an option if the kidneys or lungs have suffered significant damage.