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Lee and Haynes<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> describe for the first time a case of carotid arteritis, stroke and systemic sclerosis that histologically corresponded with a central nervous system vasculitis. More have subsequently appeared, but the cases are always insufficient for a more detailed analysis of the likely factors influencing the pathogenesis, and even the different ways they are presented in regard to vasculitis in patients without systemic sclerosis.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The micro- and macro-vascular involvement in this disease, however, appears to be more studied. Cutolo et al. describe a number of patients with limited systemic sclerosis and note that more than half had cerebral hypoperfusion demonstrated by angio-NMR, despite being asymptomatic.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> In most cases it is difficult to discern between vasculitis per se and vascular disease: the experience is reduced to daily clinical practice, and biopsy of the central nervous system is, in many instances, not feasible.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The diagnosis of any involvement of the central nervous system in these patients is a challenge for the clinician. We believe the contributions of clinical cases are of great interest, given their infrequency, as is the importance of early treatment.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Tejera Segura B, Ferraz-Amaro I. Respuesta. Med Clin (Barc). 2016;146:283.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carotid arteritis and cerebral infarction due to scleroderma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.E. Lee" 1 => "J.M. 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Journal Information
Vol. 146. Issue 6.
Pages 283 (March 2016)
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Vol. 146. Issue 6.
Pages 283 (March 2016)
Letter to the Editor
Reply
Respuesta
Beatriz Tejera Segura
, Ivan Ferraz-Amaro
Corresponding author
Servicio de Reumatología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
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Med Clin. 2016;146:282-310.1016/j.medcle.2016.05.010
Gabriel Horta-Baas, Imelda Vergara-Sánchez, Maria del Socorro Romero-Figueroa
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