الفهرس 
Acknowledgements
Etiopathogenesis of Systemic sclerosisOnly 14 pages are availabe for public view
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Abstract
Systemic sclerosis (SSc, scleroderma) is a disease of unknown etiology characterized by fibrosis of the skin and internal organs, pronounced vasculopathy, and dysregulated immune system. Activation of T lymphocytes and macrophages is an early event in the pathogenesis of SSc.(221) Pulmonary complications of SSc are one of the main causes of morbidity and mortality in the course of SSc. ILD is one of the major types of lung involvement.(144) Most of the patients present with cutaneous involvement (Raynaud’s phenomenon, sclerodactyly) before the time when ILD is identified. There is an increased risk of early developing of ILD in diffuse cutaneous systemic sclerosis.(222) Pulmonary arterial hypertension and subsequent right heart failure are very important risk factors in patients with SSc. Pulmonary fibrosis and pulmonary vascular damage lead to restriction of blood circulation and result in PAH. Pulmonary arterial hypertension affects about 15% of scleroderma patients and leads to right heart failure.(223) In patients with SSc, increased MIF expression in the skin, elevated serum levels of MIF, and a functional promoter polymorphism in the MIF gene that might influence clinical expression have been described Therefore, MIF might have an important role in the disease. The aim of our study was to investigate lung fibrosis and vascular involvement of pulmonary artery in patients with SSc and its relationship with MIF and correlation with manifestations of SSc. The current study was carried out at Rheumatology and Rehabilitation outpatient and inpatient clinics in Assiut University Hospital.