A 6-Year Statistical Study of Systemic Sclerosis in the Region of Casablanca-Settat, Morocco

Abstract

Systemic sclerosis is a non-organ-specific autoimmune disease of the connective tissue, characterized by excessive production of collagen leading to fibrosis of the skin as well as organs such as the lung, it is responsible for aesthetic discomfort, an alteration of the functional prognosis and potentially life-threatening due to damage to the heart, lungs and kidneys. We, therefore, decided to carry out a retrospective study extending over 6 years at the Internal Medicine Department and Geriatrics Unit of the Ibn Rochd University Hospital Center in Casablanca that concerned the medical files of 2164, in order to see if systemic scleroderma in our region presented any particularities. We noted that scleroderma was relatively rare in our context with only 42 patients in whom the diagnosis was made in 06 years with a female predominance (the sex ratio in our studies was 4.25 women for 1 man), we noticed that the provinces the most concerned are Casablanca, El Jadida and Settat with a predominance in urban areas, that the family history of scleroderma or autoimmune disease is weakly present in our context, the main profession at risk found in our context is automobile sheet metal work and it concerned 3 male patients (7.14%), exposure to tobacco was however present in 11 patients or 26.9%. We also noted that the first symptoms were diverse (arthralgia, myalgia, Raynaud's phenomenon) and often appeared between 1 and 5 years (in 59.6% of patients) before the diagnosis to be made. The clinical picture is classic with varied skin involvement in 100% of our patients with abnormalities on capillaroscopy in 95.2% of our patients, orofacial involvement in 54.8% of patients, muscular involvement in 57.1%, joint damage in 64.3%, bone damage in 23.8%, lung damage in 61.9%, heart damage in 23.8%, kidney damage in 26.2%, digestive damage in 54.8%, and urogenital involvement in 33.3% of patients. 7 patients died (16.66%), 3 patients (7.14%) had progression of the disease leading to complications, and 20 patients (47.61%) reported improvement while the disease remained stationary in 11 patients (26.19%).