Laboratory Findings Full-blown systemic sclerosis is readily diagnosed on clinical grounds. The nonspecific antibody and HLA typing are largely of research interest. The ANA often show an antinucleolar pattern. The course is variable and unpredictable and often progresses slowly. Most patients eventually show evidence of visceral involvement.
Prognosis is poor if cardiac, pulmonary, or renal manifestations are present early.
Treatment No drug has significantly influenced the natural history of systemic sclerosis, but various drugs are of value in treating specific symptoms or organ systems. Physiotherapy may help preserve muscle strength but is ineffective in preventing joint contractures. For renal disease, ACE inhibitors are the drugs of choice. All of these drugs effectively control hypertension and help preserve renal function. When end-stage renal disease is unpreventable, dialysis and transplantation can be used, although the mortality rate remains high.