Some patients with systemic sclerosis may develop a pseudo-obstruction. Dein et al identified risk factors for this complication. The authors are from the Johns Hopkins University.
Patient selection: systemic sclerosis
Clinical features of pseudo-obstruction: severe abdominal pain, abdominal distention, bloating, inability to tolerate an oral diet.
Risk factors for pseudo-obstruction in multivariate analysis:
(1) older age at first symptom (HR 1.02)
(2) male sex (HR 1.8)
(3) diffuse cutaneous type (HR 2.5)
(4) myopathy (HR 1.8)
(5) history of opioid exposure (HR 2.4)
Protective factors:
(1) autoantibodies to RNA polymerase-3 (HR 0.34)
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