Clinical manifestations and antibody associations in systemic sclerosis: Insight from a single-center cohort.

Abstract

Objective: To describe the clinical manifestations and autoantibody associations in patients with systemic sclerosis (SSc) at a tertiary care center in Pakistan. Study Design: Prospective Cross-sectional Comparative Observational study. Setting: Department of Rheumatology, Fauji Foundation Hospital, Rawalpindi, Pakistan. Period: January 2019 to December 2025. Methods: Forty-seven consecutive patients fulfilling the 2013 ACR/EULAR classification criteria for SSc were enrolled. Clinical subtypes (dcSSc vs lcSSc), organ involvement (HRCT for ILD, echocardiography for suspected PH), and SSc-specific autoantibodies were recorded. Data were analysed using SPSS. Results: Mean age was 41.2 ± 11.8 years; 61.7% had dcSSc. Raynaud’s phenomenon was universal (100%). ILD was present in 73.3% with no significant difference between dcSSc (75.0%) and lcSSc (70.6%) (p=0.746). Anti-Scl-70 was the most common autoantibody (40.4%) and anticentromere antibody (ACA) was exclusively seen in lcSSc (27.8% vs 0%, p=0.008). No significant antibody–organ associations were found. Conclusion: This Pakistani cohort showed a uniformly high burden of ILD across both cutaneous subtypes and the classical ACA–lcSSc association. Universal ILD screening is warranted irrespective of subtype or autoantibody profile.