Disease-related malnutrition in systemic sclerosis: Evidences and implications

The present review summarises evidences and provides recommendations for the screening and management of malnutrition in systemic sclerosis (SSc). This complication is frequently underestimated when assessing patients and this may lead to an impaired estimation of prognosis. The presence of malnutrition is indicated by anthropometric and biohumoral changes reflecting protein stores (low serum prealbumin) and influenced by organ involvement in SSc (skin and the gastrointestinal tract). Patients at high risk of malnutrition or with low prealbumin levels have shown increased mortality risk and, therefore, a nutritional assessment is mandatory in every SSc patient. This screening is especially important as malnutrition represents a potentially modifiable risk factor with nutritional interventions. The pillars of nutritional treatment are also discussed.