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Anti-Centromere Clinical Subset — SCE Rheumatology MCQ

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HardSystemic SclerosisAnti-Centromere Clinical SubsetSCE Rheumatology

A 68-year-old develops rapidly progressive diffuse cutaneous systemic sclerosis and is anti-RNA-polymerase-III positive. There is no known malignancy. Which risk response best reflects BSR guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Monitor for renal crisis and undertake enhanced baseline malignancy assessment

Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E

D is correct. Anti-RNA-polymerase III and rapidly progressive diffuse disease identify renal-crisis risk and a temporally clustered cancer phenotype; BSR supports vigilant BP/renal monitoring and enhanced baseline malignancy assessment in high-risk adults. A reverses both associations. B is not proven prophylaxis and may complicate recognition of renal crisis. C adds a steroid-related renal-crisis hazard. E confuses this specificity with anti-centromere-associated PBC risk.

Reference: BSR systemic sclerosis guideline 2024: https://academic.oup.com/rheumatology/article/63/11/2956/7750184