Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 28, 2011; 17(12): 1606-1613
Published online Mar 28, 2011. doi: 10.3748/wjg.v17.i12.1606
Is spleen circulation impaired in systemic sclerosis and what is the role of liver fibrosis?
Giovanni Tarantino, Angelo Spanò, Gabriella Loi, Anna Parisi, Marianna Tarantino, Giuseppina Brancaccio, Giovanni Battista Gaeta, Antonio Riccio
Giovanni Tarantino, Angelo Spanò, Gabriella Loi, Anna Parisi, Antonio Riccio, Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, 80131 Naples, Italy
Marianna Tarantino, Department of Biomorphological and Functional Sciences, Federico II University Medical School of Naples, 80131 Naples, Italy
Giuseppina Brancaccio, Giovanni Battista Gaeta, Department of Infectious Diseases, Second University of Naples, 80131 Naples, Italy
Author contributions: Tarantino G conceived of the study, carried out the statistical analysis and drafted the manuscript; Riccio A, Spanò A and Gaeta GB critically revised the manuscript; Loi G and Parisi A carried out the clinical investigation; Tarantino G performed ultrasonography; Brancaccio G performed transient elastography; all authors read and approved the final manuscript.
Supported by Funds of the Department of Clinical and Experimental Medicine of the Federico II University
Correspondence to: Giovanni Tarantino, Professor, Department of Clinical and Experimental Medicine, Federico II University Medical School of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy. tarantin@unina.it
Telephone: +39-81-7462024 Fax: +39-81-5466152
Received: July 9, 2010
Revised: September 27, 2010
Accepted: October 4, 2010
Published online: March 28, 2011
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Splenic artery resistivity index, Doppler ultrasound, Transient elastography, Nailfold capillaroscopy, Systemic sclerosis, Liver fibrosis