Sistemik sklerozlu hastalarda dijital ülser oluşumu ve periferik nöropati ilişkisinin değerlendirilmesi

Objective: Quantitative Sensory testing (QST) is a non-invasive method used in the diagnosis and classification of peripheral neuropathies. This study aimed to evaluate peripheral small and large fibers involvement by QST in patients with systemic sclerosis and to evaluate its relationship with digital ulcer formation. Methods: Patients with systemic sclerosis who applied to the rheumatology unit between April and September 2013 were included in the study. All patients were evaluated with a detailed medical history and physical examination. Imaging and laboratory results and information on organ involvements were obtained from hospital files. Patients were evaluated with QST to determine large and small fibers involvement. Results: The study was conducted with 50 (92% female) systemic sclerosis patients. The mean age was 47±12 years, the mean disease duration was 11.3±7.2 years. Sixty-six percent (n=33) of the patients had a history of digital ulcer and/or pitting scar. In QST evaluation, 84% (n=42) of patients had abnormality in vibration and/or cold detection thresholds. The number of patients with upper extremity vibration detection threshold abnormality was higher than that of the patients with lower extremity abnormality (74% vs 40%). There was no statistically significant difference between the groups with and without QST abnormalities regarding the clinical features including digital ulcer/pitting scar history (p>0.05 for all). Conclusion: In this study, significant number of patients with systemic sclerosis had QST abnormality, which is evident in the vibration detection thresholds. Longitudinal studies in early systemic sclerosis patients are needed to determine the clinical importance of QST.