{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:21:03Z","timestamp":1760188863350},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,12,9]],"date-time":"2005-12-09T00:00:00Z","timestamp":1134086400000},"content-version":"vor","delay-in-days":4666,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[1993,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We describe a 15\u2010year\u2010old girl with biopsy\u2010proven morphea who developed progression to systemic disease 2 years after initial presentation. In contrast to other reported patients with localized scleroderma, some of whom have had mild, nonprogressive systemic involvement, this patient developed severe, debilitating disease, with skin tightness, sclerodactyly, esophageal involvement, restrictive pulmonary disease, and myopathy. From the time of her initial evaluation, the patient was positive for antinuclear antibodies (ANA), which were shown to be primarily directed against the Ku antigens. This observation suggests that ANA may be a prognostic indicator for progression to systemic disease.<\/jats:p>","DOI":"10.1002\/art.1780360318","type":"journal-article","created":{"date-parts":[[2007,2,15]],"date-time":"2007-02-15T00:46:54Z","timestamp":1171500414000},"page":"410-415","source":"Crossref","is-referenced-by-count":52,"title":["Localized scleroderma progressing to systemic disease. case report and review of the literature"],"prefix":"10.1002","volume":"36","author":[{"given":"Nina","family":"Birdi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald M.","family":"Laxer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Thorner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvin J.","family":"Fritzler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Earl D.","family":"Silverman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,12,9]]},"reference":[{"key":"e_1_2_1_2_2","volume-title":"Antinuclear antibodies and the connective tissue diseases, Laboratory Diagnostic Procedures in the Rheumatic Diseases","author":"Fritzler MJ","year":"1985"},{"key":"e_1_2_1_3_2","volume-title":"Autoantibodies to ribonucleoprotein particles by immunoblotting, Manual of Clinical Laboratory Immunology","author":"Chan EKL","year":"1992"},{"key":"e_1_2_1_4_2","first-page":"107","article-title":"Sclerodermie en plaques: perturbations imunologiques et viscerales","volume":"129","author":"Bourgeois\u2010Drouin C","year":"1978","journal-title":"Ann Med Interne (Paris)"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1956.01550120049012"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.33.7.928"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)30624-1"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(87)70251-5"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1001\/archderm.1987.01660270088021","article-title":"Antinuclear and anti\u2010single stranded DNA antibodies in morphea and generalized morphea","volume":"123","author":"Falanga V","year":"1987","journal-title":"Arch Dermatol"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(87)70229-1"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1958.01560120069011"},{"issue":"2","key":"e_1_2_1_12_2","first-page":"343","article-title":"Scleroderma in childhood","volume":"20","author":"Kornreich HK","year":"1977","journal-title":"Arthritis Rheum"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1979.tb01636.x"},{"key":"e_1_2_1_14_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1001\/archderm.1980.01640260045011","article-title":"Disabling pansclerotic morphea of childhood","volume":"116","author":"Diaz\u2010Perez L","year":"1980","journal-title":"Arch Dermatol"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230510"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-6-849"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI110295"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.161.1.18"},{"key":"e_1_2_1_19_2","first-page":"366","article-title":"Antibodies against Ku protein in sera from patients with autoimmune diseases","volume":"76","author":"Yaneva M","year":"1989","journal-title":"Clin Exp Immunol"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780260506"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90647-4"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.41.4.382"}],"container-title":["Arthritis &amp; 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