INITIAL VISCERAL INVOLVEMENT IN DIFFUSE S CLERODERMA

Progressive systemic sclerosis (PSS) is characterized in most patients by initially unspecific symptoms like acrocyanosis, Raynaud's phenome non, general malaise or acral paresthesia. Clinical manifestations app ear with an edematous-inflammatory stage of disease leading to a chron ic-progressive phase with increasing fibrosclerosis of the skin and in ternal organs. Dermal involvement and the demonstration of immunopatho logical abnormalities in the peripheral blood precede visceral fibrosi s in most cases. We report on an unusual case of diffuse PSS with prec eding involvement of internal organs. Early visceral fibrosis is demon strated by histomorphological results and is correlated with laborator y findings. Serum antinuclear antibodies could not be obtained until 4 months ante finem and the liver was also involved in the fibrotic pro cess.