[Clinical and serological diversity in systemic sclerosis].

Systemic sclerosis (SSc) is a multisystem connective tissue disease characterized by vascular damage with non-specific inflammation and progressive fibrosis. The disease exhibits a large heterogeneity in both clinical and serological features. This diversity refers to the course of the disease, which is difficult to predict in many cases. Although poor prognostic factors are well known, it is not always possible to predict the course of the disease and the prognosis. Furthermore, the activity of disease is difficult to assess since both reversible and irreversible lesions can occur in one patient. To date, numerous attempts have been made to assess the SSc activity. In 2017 the disease activity score was updated. Discrimination between an active phase of the disease and the disease with irreversible organ changes is of particular importance, when immunosuppressive treatment is considered, as this kind of therapy should be used in cases with active, reversible lesions. Moreover, while assessing the course of the disease, special attention is paid to the effects of serological markers on clinical symptoms and severity of the disease. Numerous ongoing studies focus on new serological biomarkers and their influence on internal organ involvement. This paper analyses our observations and presents literature review to determine the importance of various clinical and serological symptoms and their association with the course and the prognosis of SSc.