Title: CREST Syndrome Clinical Presentation: History, Physical Examination, Complications
Headings: CREST Syndrome Clinical Presentation
CREST Syndrome Clinical Presentation
History
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectases
Other manifestations

Content: Myocardial involvement is rare in patients with limited scleroderma; however, patchy fibrosis in the myocardium can occur and typically is asymptomatic. Significant myocardial involvement manifests as dyspnea on exertion, fatigue, and palpitations. Arrhythmias and conduction abnormalities can occur. [ 50]
Primary biliary cirrhosis may be associated with CREST syndrome. [ 51, 52]
Renal crises rarely occur in persons with limited scleroderma (1%); they manifest accelerated hypertension, renal failure, and microangiopathic hemolytic anemia. Entrapment neurologic syndromes (eg, carpal tunnel syndrome) occur. Autonomic dysfunction of the GI tract also occurs. Sicca symptoms are present in approximately 35% of patients.