Which internal organ changes are included in the 2013 classification criteria for systemic sclerosis?

• A. gastrointestinal and cardiac
• B. pulmonary arterial hypertension and pulmonary fibrosis
• C. pulmonary fibrosis
• D. cardiomyopathy

Answer: (B)

The key idea is which internal organ changes are counted in the 2013 ACR/EULAR classification criteria for systemic sclerosis. The scoring system includes certain organ manifestations that help differentiate SSc from other diseases, and among internal organ involvement, pulmonary arterial hypertension (PAH) and interstitial lung disease (pulmonary fibrosis) are specifically included as features that contribute to the classification. This reflects the characteristic vascular and fibrotic processes of systemic sclerosis and their impact on prognosis.

Gastrointestinal and cardiac involvement are common in systemic sclerosis, but they are not part of the scoring items in the 2013 criteria, so they don’t directly drive classification.