- Analysis for antinuclear antibodies (ANA) to the extracted nuclear antigen, antibodies to the Smith antigen (Sm) and antibodies to DNA
- Organ pathology is determined in accordance with the clinical signs
SST should be suspected in all patients suffering from SLE, systemic scleroderma, or polymyositis, with the development of additional cross-clinical manifestations.
First of all, it is necessary to determine ANA, antibodies to U1 ribonucleoprotein. Almost all patients have high ANA titers of the speckled glow type. Antibodies to U1 ribonucleoprotein are usually present in a very high titer. Antibodies to the ribonuclease-resistant component of the extracted nuclear antigen (CM-antigen) and double-stranded DNA (negative in SZST) are measured to exclude other diseases.
Rheumatoid factor (RF) is often detected, the titers of which should be high. Often the level of ESR is increased.
Pulmonary hypertension should be detected as early as possible by a pulmonary functional test and echocardiography. The plan for further studies depends on the existing symptoms of organ and system damage: the presence of signs of myositis, kidney and lung damage requires appropriate diagnostic methods (in particular, creatine kinase, MRI, electromyography, muscle biopsy).
In general, the ten-year survival rate is about 80%, but the prognosis largely depends on the prevailing symptoms. It is worse for patients with signs of systemic scleroderma and polymyositis. Patients have an increased risk of atherosclerosis. The main causes of death are pulmonary hypertension, renal failure, myocardial infarction, colon perforation, disseminated infections, and cerebral hemorrhage. Some patients remain in persistent remission for many years without treatment.
- NSAIDs and aminoquinoline drugs in the mild form of the disease
- Corticosteroids and other immunosuppressants (for example, methotrexate, azathioprine, mofetil mycophenolate) in moderate to severe diseases
- Calcium channel blockers (e.g., nifedipine) and phosphodiesterase inhibitors (e.g., tadalafil) for the Raynaud phenomenon
The initial and maintenance treatment for patients with SLE is selected according to the clinical picture; it may be similar to the treatment for SLE or depend on the dominant clinical phenotype.
All patients should be monitored for signs of atherosclerosis. When conducting long-term treatment with glucocorticoids, prevention of osteoporosis should be carried out.
Some experts recommend periodic screening for pulmonary hypertension with a lung function test and / or echocardiography every 1-2 years, depending on the symptoms.