Systemic sclerosis may affect internal organs in addition to the skin. Medsger et al developed severity scales to grade severity of end-organ damage in affected organs. The authors are from multiple universities in North America and Europe.
Parameters:
(1) serum creatinine
(2) proteinuria
(3) peristalsis in the esophagus
(4) other changes in the GI tract
Renal Severity Scale (RSS)
Serum Creatinine |
Proteinuria |
RSS Grade |
normal |
normal |
0 (normal) |
1.3 to 1.6 mg/dL |
2+ |
1 (mild) |
1.7 to 2.9 mg/dL |
3 to 4+ |
2 (moderate) |
>= 3.0 mg/dL |
NA |
3 (severe |
dialysis required |
NA |
4 (endstage) |
GI Severity Scale (GISS)
Esophageal Peristalsis |
Other GI Tract Findings |
GISS Grade |
normal |
normal |
0 (normal) |
decreased |
abnormal small bowel series |
1 (mild) |
aperistalsis |
bacterial overgrowth |
2 (moderate) |
NA |
malabsorption andor pseudo-obstruction |
3 (severe |
NA |
hyperalimentation |
4 (endstage) |
Purpose: To evaluate a patient with scleroderma for renal and gastrointestinal involvement using the scales of Medsger et al.
Specialty: Immunology/Rheumatology
Objective: imaging studies, severity, prognosis, stage, response to therapy, disease progression
ICD-10: M34,