MEDizzy - A 34-year-old woman presents to the clinic complaining of

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General Gastroenterology

A 34-year-old woman presents to the clinic complaining of severe heartburn, ulcers on her finger tips, and discomfort in her hands in cold weather or while washing with cold water. She describes the hands becoming pale and painful with cold exposure and then becoming red on rewarming. On physical examination, the pertinent findings are healing lesions of the fingertips that she says were small ulcers, and there are small areas of telangiectasias on her face. Esophageal manometry reveals a decrease in the expected amplitude of smooth muscle contraction. Lower esophageal sphincter tone is subnormal, but relaxes normally with swallowing. Which of the following statements regarding this condition is most likely correct?

Explanation(B) These findings are characteristic of scleroderma, and esophageal symptoms should be treated with medications for acid suppression. If the disease is limited, the prognosis is not necessarily poor. The limited form is characterized by calcinosis, Raynaud’s (often with distal ulceration), esophageal motility disorder, sclerodactyly, and telangiectasia (CREST syndrome). It has a female preponderance, and renal disease can be severe, but is not the most common cause of death.