title: Is spleen circulation impaired in systemic sclerosis and what is the role of liver fibrosis?
abstract: OBJECTIVE
  To investigate the spleen vascular involvement and the presence of liver fibrosis in a population of subjects with established systemic sclerosis (SSc).
  
  
  METHODS
  In a cross-sectional fashion, 17 patients with SSc were compared with 18 patients suffering from hepatitis C virus (HCV)-related liver cirrhosis, grade A and B Child-Pugh classification. Eighteen non elderly subjects, apparently healthy, were used as the control group. Splenic artery resistivity index (SARI) at Doppler ultrasound, transient elastography of liver and nailfold capillaroscopy were the main outcomes.
  
  
  RESULTS
  Transient elastography values of SSc patients were similar to those of controls; 5.2 ± 1.1 vs 4.5 ± 1, (P = 0.07). Median Alanine amino transferase (ALT) concentrations of cirrhotic patients were greater than those of controls and SSc patients, i.e. 66.5 (36-89) U/L vs 29 (22-34) U/L and 31 (22-41) U/L, respectively, (P = 0.005). SARI determinations in cirrhotic patients, although significantly higher than those found in controls and SSc patients, showed some degree of overlap with SSc patients, i.e. 0.59 vs 0.52 and 0.57, respectively, (P = 0.04). Mean systolic blood pressure was significantly higher in SSc patients than in cirrhotics and controls, i.e. 142 mmHg vs 128.2 mmHg and 127 mmHg, respectively, (P = 0.005). Mean diastolic blood pressure behaved in a similar fashion, i.e. 84 mmHg vs 72.2 mmHg and 76.9 mmHg (P = 0.005). Nailfold Capillaroscopy grades and diastolic blood pressure values correlated well with SARI results.
  
  
  CONCLUSIONS
  An enhanced resistivity of the splenic artery was found in patients suffering from SSc; they did not have evidence of splenomegaly as well as no liver fibrosis or any other form of liver damage.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, 80131 Naples, Italy. tarantin@unina.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tarantino
authors.forename: Angelo
authors.initials: A
authors.lastname: Spanò
authors.forename: Gabriella
authors.initials: G
authors.lastname: Loi
authors.forename: Anna
authors.initials: A
authors.lastname: Parisi
authors.forename: Marianna
authors.initials: M
authors.lastname: Tarantino
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Brancaccio
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Gaeta
authors.forename: Antonio
authors.initials: A
authors.lastname: Riccio
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure; D002196:Capillaries / Q000503:physiopathology; D016009:Chi-Square Distribution; D054459:Elasticity Imaging Techniques; D005260:Female; D005385:Fingers / Q000098:blood supply; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000503:physiopathology* / Q000821:virology; D016015:Logistic Models; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D016017:Odds Ratio; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D013152:Splanchnic Circulation; D013154:Spleen / Q000098:blood supply*; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance