Annual Specialist Control (Rheumatologist) / Follow-up

Disease history

New symptoms

• Eyes (dryness)
• Mouth and throat (dryness)
• Esophagus (swallowing problem, acid reflux)
• Heart (Pain, Irregular heart rate, Dyspnoea, Edema)
• Lungs (cough, dyspnoea)
• Kidneys (Edema, high blood pressure)
• Skin
• Raynaud's phenomenon
• Stomach / Intestine
  • Abdominal pain: GIFT: Gastro-antral venous ectasia
  • Stomach acid-Reflux
  • Commercial Recordings
  • Incontinence for stools
• Weight loss last year

Examinations

General

• Auscultation of the heart (Imagery)
• Auscultation of the lungs (Basalt crepes)
• Blood pressure and heart rate (rhythm and frequency)
• Dyspnea
• Weight and height
• Edema

Blood and urine

• cell counts
• Electrolytes (Sodium, Potassium, Calcium)
• Liver and kidney function tests
• albumin
• Pro-BNP
• In case of weight loss or other suspicion of reduced nutrition
  • albumin
  • Vitamin D
  • Folic acid
  • Transfer step saturation (iron uptake)
  • Vitamin B12
• Urine Sticks (erythrocytes, protein, nitrite, glucose)

Physical function

• 6 minutes walking test

Heart

• ECG
• Echocardiography to rule out pulmonary hypertension (PAH)

Skin

• Calcinosis
• Capillaries
  • Video capillaroscopy
• Carp Mouth
• Pigment changes (Salt and pepper)
• Raynaud's phenomenon
• Rodnan Skin Score (Khanna D, 2017)
• Sclerodactylia
• Wounds on the finger pulp
• Telangiectasia

Lungs

• Lung Function Tests (LFT)
  • If FVC has been reduced by more than 10% or DLCO by more than 15%, further investigation with HRCT of the lungs is applicable
• HRCT examination if markedly reduced LFT

First time survey

Adds the following:

• Blood tests
  • Antinuclear antibody (ANA) with subgroups
    • CENP (Limited form)
    • SCL70 (Diffuse form)
    • SLC75 / 100 (Sclero-myositis)
    • RNA polymerase III
    • CK (Scleromyositis
• HRCT lungs
• X-ray (dynamic) with esophageal contrast agent (Esophagus)

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