L’HTA au cours de la sclérodermie systémique : une urgence vitale

Abstract

PurposeIn systemic sclerosis, hypertension is feared because it is often heralding severe renal impairment. The objective of our study was to identify the frequency of arterial hypertension and clarify its etiologies in this condition. Patients/methodsOur study was prospective. From January 2008 to May 2012, we have included all patients over the age of 16 years which featured a systemic scleroderma meeting the criteria for classification of Leroy and Medsger modified. Blood pressure was systematic and hypertension was defined as a greater than 140/90mmHg PAS/PAD. ResultsWe have collected 60 patients. It was 50 women and 10 men with an average age of 41.1ans±13.03. Arterial hypertension was noted in sixteen patients (26.7%) with an average age of 48.8 years±13.21. It was nine diffuse cutaneous systemic scleroderma of six limited cutaneous scleroderma and one case of scleroderma sine scleroderma. Etiologic research hypertension had concluded to a renal cause in 12 patients. It was five scleroderma renal crisis (SRC), three vascular nephropathies, four chronic kidney failure (CKD) including three terminals and a moderate CKD. An ‘essential’ so-called HTA was observed in four patients. Hypertension was a major sign that reported five cases of SRC. These patients had received treatment anti hypertensive and renal extra cleansing. DiscussionHypertension is common in systemic scleroderma. Our data approximates of literature when its frequency and severity. ConclusionHypertension is a major warning sign that under no circumstances should overlook it or novo or secondary aggravation. Its support must be very early under penalty to put at stake the life-threatening in particular during the CRS.