Abstract Body

Background and purpose: Scleroderma is a chronic rheumatological disease, characterized by the production of fibrous tissue, mainly in the skin but also in other organs. It’s not common in the daily routine of the family doctor becoming a challenge.

Methods: Case report

Results: Mr.O.A., 57 years old, caucasian, CEO of a radical activities company. Non-relevant medical history, no usual medication. Healthy eater, works out regularly. Denies any rheumatological pathology in the family's history.

Came to acute pathology’s consultation. Complementary diagnostic tests were requested: Hb 7.9 g/dl, HT 27.2%, VGM 60fL, not compatible with the normal physical exam. Repeats blood count and complements study of anemia: signs of gastropathy and H.Pylori infection were identified.

Starts to show signs of raynaud phenomenon associated with diffuse edema of the hands and face, sense of lower physical performance, stuttering and genitourinary symptoms (difficulty in urination, polyaquiauria and sexual impotence). Complemented the study: microalbuminuria ratio 199.4, VS 15, ANA 1:1280.

Was referred to the Rheumatology consultation. Signs of skin thickening were identified (RODNAN 19). In the additional hospitalar study, were found positive Scl-70 antibodies, abnormal capillaroscopy and signs of renal and lung involvement. The diagnosis of diffuse cutaneous systemic sclerosis was established.

Conclusions: Rheumatological pathology is a puzzle in which the pieces are not always all visible or fit in the signs and symptoms described by the patient, turning it into an adventure, shared with the patient, with the aim to reach the diagnosis.