{
  "abstract": "Introduction The association between systemic sclerosis (SSc) and neoplastic disorders is well known. The incidence of cancers in SSc patients ranges from 3.6 to 10.7%. Paraneoplastic SSc can occur at any time of cancer manifestation. However, in some cases, paraneoplastic SSc can be induced by cancer treatment.Material and Methods -Results A 67-year-old female, diagnosed with adenocarcinoma of the right lung, started treatment with cisplatin and pemetrexed. Two days after administration of chemotherapy, ischaemia of II, IV, and V fingers of both hands occurred. The persistent presence of pale digits and pain was not specific to Raynaud’s syndrome. Additional tests, such as coagulation parameters, USG doppler of upper limb arteries, capillaroscopy, ANCA, anti-endothelial cell, and antiphospholipid antibodies, were normal. Anti-centromere antibodies (ACA) were positive. Two weeks of combination therapy with calcium channel blockers, PDE5 inhibitors, enoxaparin, acetylsalicylic acid, and pentoxifylline were unsuccessful. The first necrotic changes began to appear on fingertips, so treatment with intravenous infusions with prostaglandin E1 agent (alprostadil alfadeks) was started. After the implementation of the above therapy, stabilization of the local condition was observed, as well as the formation of necrotic changes in the distal phalanges, which later self-amputated. A few months later, Raynaud’s phenomenon and puffy fingers occurred, which allowed for the diagnosis of paraneoplastic SSc.Conclusions The most common malignancies associated with SSc are lung and breast cancers. Treatment with drugs such as docetaxel, paclitaxel, bleomycin, and gemcitabine may lead to scleroderma-like syndromes. The presence of ACA antibodies, lung cancer, and the effect of cisplatin with pemetrexed resulted in finger ischemia and the subsequent development of SSc symptoms.Abstract P.356 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdansk, Poland, Gdansk, Poland"
      ],
      "name": "Anna Wojteczek"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdansk, Poland, Gdansk, Poland"
      ],
      "name": "Monika Gosz"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdansk, Poland, Gdansk, Poland"
      ],
      "name": "Michal Chmielewski"
    }
  ],
  "title": "P.356 Digital ischaemia associated with paraneoplastic systemic sclerosis",
  "uid": "7679005e-5725-573a-a358-4fb5e09ae931"
}