Which physiologic derangement is NOT associated with scleroderma?

Scleroderma, also known as systemic sclerosis, is a connective tissue disease characterized by the hardening and tightening of the skin and connective tissues. The physiological derangements associated with scleroderma arise from this excessive collagen deposition and its effects on various organ systems.

Myocardial fibrosis is a common complication of scleroderma due to the fibrosis of heart tissues, which can lead to cardiomyopathy and arrhythmias. Esophageal dysmotility is also frequently observed in patients with scleroderma because the esophagus can become stiff and lose its normal wave-like contractions, leading to digestive issues. Pulmonary hypertension occurs as a result of vascular changes in the lungs, which can be exacerbated by the fibrotic processes in scleroderma.

In contrast, excessive oral secretions and salivation is not a characteristic feature of scleroderma. Patients typically experience dry mouth (xerostomia) instead of increased salivation due to the damage to the salivary glands caused by the disease. Thus, the lack of association with excessive oral secretions and salivation distinguishes this option from the other physiological derangements commonly linked to scleroderma.