title: Clinical and autoantibody profile in systemic sclerosis: baseline characteristics from a West Malaysian cohort.
abstract: OBJECTIVE
  To evaluate the clinical and antibody profile of systemic sclerosis (SSc) in a Malaysian cohort.
  
  
  METHODS
  Consecutive patients with SSc in University Malaya Medical Centre from March to November 2012 were included in this study. In addition to clinical characterization, all subjects underwent autoantibody testing using Euroline immunoblot assay. The association between clinical features and autoantibody profile was evaluated.
  
  
  RESULTS
  There were 31, predominantly Chinese (45.2%), subjects. Limited cutaneous disease was the most common subtype (71%). Raynaud's phenomenon was the most commonly observed feature (83.9%). Nine (29%) had esophageal dysmotility symptoms and 23 (74.2%), including all patients with diffuse SSc, had symptoms of gastro-esophageal reflux disease (GERD). Restrictive pattern on pulmonary function test and evidence of lung fibrosis were seen in more than 70% of patients. Echocardiographic evidence of pulmonary arterial hypertension was seen in 58.1%. Telangiectasia, calcinosis, digital ulcers, digital pulp loss or pitting were seen more commonly in the diffuse subtype. The two most prevalent autoantibodies were anti-Scl-70 and anti-Ro-52. The presence of anti-Scl-70 was significantly associated with restrictive lung disease (P = 0.05). Anti-Ro-52 was associated with control subjects with other autoimmune diseases (P = 0.043). The presence of anti-PM-Scl-75 was associated with overlap syndrome (P = 0.032). Patients with anticentromere antibodies were more likely to have vasculitic rash (P = 0.012).
  
  
  CONCLUSIONS
  In Malaysia, SSc most commonly affects the Chinese. Limited cutaneous is more common than diffuse subtype. Features of CREST (calcinosis, Reynaud disease, esophageal dysmotility, sclerodactyly, telangiectasia) are more commonly observed in the diffuse cutaneous subgroup. Anti-Scl-70 and anti-Ro-52 antibodies are promising biomarkers for pulmonary involvement in SSc.
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sujau
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chin Teck
authors.initials: CT
authors.lastname: Ng
authors.affiliation: Division of Laboratory Medicine, Department of Pathology, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Pavai
authors.initials: P
authors.lastname: Sthaneshwar
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sargunan
authors.initials: S
authors.lastname: Sockalingam
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Tien Eang
authors.initials: TE
authors.lastname: Cheah
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Fariz
authors.initials: F
authors.lastname: Yahya
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Raja
authors.initials: R
authors.lastname: Jasmin
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D044466:Asian People / Q000706:statistics & numerical data; D001323:Autoantibodies / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D035583:Rare Diseases; D018570:Risk Assessment; D012595:Scleroderma, Systemic / Q000208:ethnology / Q000276:immunology* / Q000503:physiopathology*; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric
chemical_list: D001323:Autoantibodies
keywords: Malaysia; autoantibodies; clinical profile; systemic sclerosis