This retrospective study (1996–2022) examined whether elevated platelets (≥330,000/μL), elevated CRP (≥6.0 mg/L), or both were associated with disease severity, progression, and survival in 139 adult SSc patients, categorized into four groups based on their first blood draw after symptom onset.
Patients with both elevated platelets and elevated CRP (EP/EC, n=12) had the worst outcomes: median survival of 9.6 years vs. 21.3 years in the normal platelet/normal CRP group (p<0.0001), with an adjusted HR of 7.34 (95% CI 2.40–22.41, Bonferroni-adjusted p=0.0025). EP/EC also had the highest rates of Scl-70 positivity, diffuse skin involvement, myocarditis/cardiomyopathy, digital ulcers, and the highest mRSS scores over two years.
- Small sample size, especially in the EP/EC group (n=12), limiting statistical power and generalizability. - Retrospective single-center design introduces selection bias. - FVC differences among groups over two years did not reach statistical significance, suggesting underpowering for some endpoints.
In SSc patients, the combination of elevated platelets (≥330,000/μL) and elevated CRP (≥6.0 mg/L) at first blood draw flags a high-risk subgroup with roughly 7-fold higher mortality — these patients may warrant earlier, more aggressive screening and treatment of organ complications.
