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Bioelectrical Impedance Analysis of Patients with Scleroderma as an Indicator of Severity and Activity of the Disease.

MD Arias S|Fonsalía V|Lujambio A|Ambrosoni F|Chapper C
Paper presented at the 29 World Congress of Medicine at Buenos Aires, Argentina, September 2008
OBJECTIVE: To describe seriated BIA and PA in 2 patients with diffuse Scleroderma.
SUBJECTS/METHODS: Seriated BIA was carried out in 2 patients with severe diffuse Scleroderma for eight months. Both presented a Terminal Illness according to Medger’s Severity Scale, one because of interstitial lung disease that required oxygen (AN), and the other because of a digestive compromise that required nutritional support, and finally, heart failure (AG). Both died. We took 5 and 3 measurements respectively. To perform the BIA we used BODYSTAT Quadscan 4000 & Multiscan 5000 equipment.
RESULTS: Both patients showed a progressive increase of what the device interprets as body fat (poor conductive tissue), from 18.4% to 21.2% for the first patient and from 23.3% to 24.6% for the second, having registered weight loss in both. Consequently, a progressive increase in the Resistance to the flow of current and a decrease in the Reactance (useful tissues) occurred, which lead to a dramatic fall in the Phase Angle, which varied in the first from 3.9 to 2 (days before death), and from 3.4 to 3.1 in the second (for this one, months before death).
CONCLUSION: The figures found by BIA of poor conductive tissue increase, that the device interpreted as an increase of fatty mass (poor conductor), isn’t the organism’s behaviour against malnutrition. The patients were malnourished as shows their low body mass index and it worsened as time went on. In the first patient there was an increase of lung fibrosis and probably of other tissues as well, which lead to death in respiratory failure. In the second patient the increase of fibrous tissue was manifested ostensibly through a refractory restrictive heart failure that also lead to death. The increase of Resistance, and the decrease of Reactance and Phase Angle can be correlated to the severity of the disease and they seem to be sensitive markers of its progression (activity markers). More studies are required to confirm this hypothesis.
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