Limited Cutaneous SSc — RACP Adult Medicine MCQ

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ModerateRheumatologyLimited Cutaneous SScRACP Adult Medicine

A 45-year-old woman presents with Raynaud phenomenon, sclerodactyly, and telangiectasiae. She has anti-centromere antibodies. She develops new-onset dyspnoea on exertion. What complication is she most at risk of developing?

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Correct answer: E — Pulmonary arterial hypertension

Anti-centromere antibodies are associated with limited cutaneous systemic sclerosis (formerly CREST syndrome). The most feared complication is pulmonary arterial hypertension (PAH), which occurs in up to 15% of patients with limited SSc and is a major cause of mortality. Annual screening with echocardiography and PFTs (including DLCO) is recommended. A declining DLCO in the absence of ILD should prompt investigation for PAH with right heart catheterisation.

Reference: eTG – 2025 – Rheumatology; EULAR – 2023 – SSc Screening Recommendations