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Systemic sclerosis interstitial lung disease — SCE Rheumatology MCQ

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HardConnective tissue diseasesSystemic sclerosis interstitial lung diseaseSCE Rheumatology

A 41-year-old woman with Raynaud's phenomenon has puffy fingers, reflux and tight skin extending proximal to the MCP joints. ANA is positive, anti-topoisomerase I antibody is positive and HRCT shows early basal ground-glass and reticulation. What is the most important complication to screen for?

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Correct answer: E — Interstitial lung disease progression

Anti-topoisomerase I and diffuse cutaneous systemic sclerosis are strongly associated with interstitial lung disease, and HRCT already shows early change. Pulmonary function testing and serial assessment are needed to monitor progression. PAH also requires screening in systemic sclerosis, but the data here point most directly to ILD.

Reference: BSR systemic sclerosis guideline 2024; EULAR systemic sclerosis recommendations