Abstract
Pulmonary involvement is a prominent feature in systemic sclerosis and a significant cause of morbidity and mortality. A restrictive ventilatory defect is typical and static lung volumes are usually reduced in patients with ILDs. The possibility of obstruction of small airways in progressive systemic sclerosis (SSc) has been suggested by widespread bronchiolectasis and peribronchial fibrosis noted at necropsy. A total of 46 patients with a diagnosis of SSc were retrospectively included in this study. Patients were classified according to their smoking status (never smokers, n = 34 and ex or current smokers, n = 12). Patients were also compared on the basis of the presence or not of an obstructive pattern on spirometry. The purpose of this study was to establish if SSc patients who are smokers have a different pattern of pulmonary function involvement. Our hypothesis was that smoking habit was not the only cause of air trapping and that the existence of small airway involvement secondary to SSc itself cannot be excluded.
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Diot E, Giraudeau B, Diot P, Degenne D, Ritz L, Guilmot JL et al (1999) Is anti-topoisomerase I a serum marker of pulmonary involvement in systemic sclerosis? Chest 116:715–720
Medsger TA Jr (1987) D-penicillamine treatment of lung involvement in patients with systemic sclerosis (scleroderma). Arthritis Rheum 30:832–834
Ioannidis JP, Vlachoyiannopoulos PG, Haidich AB, Medsger TA Jr, Lucas M, Michet CJ et al (2005) Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 118:2–10
Quadrelli S, Ciallella L, Catalán Pellet AC, Molinari L, Salvado A, Auad C, Spina JC (2007) Compromiso pulmonar en esclerosis sistémica. Medicina (B Aires) 67:429–435
Morgan C, Knight C, Lunt M, Black CM, Silman AJ (2003) Predictors of end-stage lung disease in a cohort of patients with scleroderma. Ann Rheum 62:146–150
O’Donnell DE (1998) Physiology of interstitial lung disease. In: Schwarz M, King T Jr, Hamilton ON (eds) interstitial lung disease. Dekker, New York
D’Angelo WA, Fries JF, Masi AT, Shulman LE (1969) Pathologic observations in systemic sclerosis (scleroderma): a study of 58 autopsy cases and 58 matched controls. Am J Med 46:428–440
Bjerke RD, Tashkin DP, Clements PJ, Chopra SK, Gong H Jr, Bein M (1979) Small airways in progressive systemic sclerosis (PSS). Am J Med 66:201–209
Cherniack RM, Colby TV, Flint A et al (1995) Correlation of structure and functions in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 151:1180–1188
Subcommittee for scleroderma criteria of the American Rheumatism Association, Diagnostic, Therapeutic Criteria Committee. (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590
Quadrelli S, Bosio M, Salvado A, Chertcoff J (2007) Valor de la espirometria para el diagnostico de restricción pulmonar. Medicina 67:685–690
Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CPM, Gustafsson P, Hankinson J, Jensen R, Johnson DC, MacIntyre N, McKay R, Miller MR, Navajas D, Pedersen OF, Wanger J (2005) ATS/ERS task force: standardisation of lung function testing. In: Brusasco V, Crapo R, Viegi G (eds) Eur Respir J 26:948–968
Bland M (2000) An introduction to medical statistics (Oxford Medical Publications). Oxford University Press, New York, p 210
Steen V, Owens G, Fino G, Rodnan G, Medsger T (1985) Pulmonary involvement in systemic sclerosis (scleroderma). Arthritis Rheum 28:759–767
Silver R, Miller K (1990) Lung involvement in systemic sclerosis. Rheum Dis Clin North Am 16:199–216
Peters-Golden M, Wise RA, Schneider P, Hochberg M, Stevens MB, Wigley F (1984) Clinical and demographic predictors of loss of pulmonary function in systemic sclerosis. Medicine (Baltimore) 63:221–231
Remy-Jardin M, Remy J, Wallaert B et al (1993) Pulmonary involvement in progressive systemic sclerosis: sequential evaluation with CT, pulmonary function tests and bronchoalveolar lavage. Radiology 188:499–506
Greenwald GI, Tashkin DP, Gong H, Simmons M, Duann S, Furst DE, Clements P (1987) Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Am J Med 83:83–92
Schneider PD, Wise RA, Hochberg MC, Wigley FM (1982) Serial pulmonary function in systemic sclerosis. Am J Med 73:385–394
Spagnolatti L, Zoia MC, Volpini E, Convertino G, Fulgoni P, Corsico A, Vitulo P, Cerveri I (1997) Pulmonary function in patients with systemic sclerosis. Monaldi Arch Chest Dis 52:4–8
Sharma O, Johnson R (2000) Study of airway obstruction in sarcoidosis: a study of 123 nonsmoking black American patients with sarcoidosis. Chest 94:343–348
Wilcox AG (2000) Small airway involvement in interstitial lung disease: radiologic evidence. Curr Opin Pulm Med 6:399–403
Shaw RJ, Djukanovic R, Tashkin DP, Millar AB, du Bois RM, Orr PA (2002) The role of small airways in lung disease. Respir Med 96:67–80
Fulmer JD, Roberts WC, von Gal ER, Grystal RG (1977) Small airways in idiopathic pulmonary fibrosis: comparison of morphologic and physiologic observations. Clin Invest 60:595–610
Kim DS (2006) Interstitial lung disease in rheumatoid arthritis: recent advances. Curr Opin Pulm Med 12:346–353
Lohrmann C, Uhl M, Warnatz K, Ghanem N, Kotter E, Schaefer O, Langer M (2004) High-resolution CT imaging of the lung for patients with primary Sjogren’s syndrome. Eur J Radiol 52:137–143
Papiris SA, Maniati M, Constantopoulos SH, Roussos C, Moutsopoulos HM, Skopouli FN (1999) Lung involvement in primary Sjögren’s syndrome is mainly related to the small airway disease. Ann Rheum Dis 58:61–64
King TE Jr (1993) Respiratory bronchiolitis-associated interstitial lung disease. Clin Chest Med 14:693–698
Johkoh T, Muller NL, Pickford HA et al (1999) Lymphocytic interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 212:567–572
Akira M, Yamamoto S, Inoue Y, Sakatani M (2003) High-resolution CT of asbestosis and idiopathic pulmonary fibrosis. AJR Am J Roentgenol 181:163–169
Newball HH, Brahim SA (1977) Chronic obstructive airway disease in patients with Sjögren’s syndrome. Am Rev Respir Dis 115:295–304
Johkoh T, Muller NL, Ichikado K et al (1999) Respiratory change in size of honeycombing: inspiratory and expiratory spiral volumetric CT analysis of 97 cases. J Comput Assist Tomogr 23:174–180
Garty BZ, Athreya BH, Wilmott R, Scarpa N, Doughty R, Douglas SD (1991) Pulmonary functions in children with progressive systemic sclerosis. Pediatrics 88:1161–1167
Vitali C, Tavoni A, Viegi G, Begliomini E, Agnesi A, Bombardieri S (1985) Lung involvement in Sjögren’s syndrome: a comparison between patients with primary and with secondary syndrome. Ann Rheum Dis 44:455–461
Andonopoulos AP, Yarmenitis S, Georgiou A, Bounas C (2001) Bronchiectasis in systemic sclerosis: a study using high-resolution computed tomography. Clin Exp Rheumatol 19:187–190
Bouros D, Wells AU, Nicholson AG, Colby TV, Polychronopoulos V, Pantelidis P, Haslam PL, Vassilakis DA, Black CM, du Bois RM (2002) Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 165:1581–1586
Travis WD, Matsui K, Moss J et al (2000) Idiopathic nonspecific interstitial pneumonia: prognostic significance of cellular and fibrosing patterns: survival comparison with UIP and desquamative interstitial pneumonia. Am J Surg Pathol 24:19–33
Katzenstein ALA, Myers JL (2000) Nonspecific interstitial pneumonia and the other idiopathic interstitial pneumonias: classification and diagnostic criteria. Am J Surg Pathol 24:1–3
Morelli S, Barbieri C, Sgreccia A, Ferrante L, Pittoni V, Conti F, Gualdi G, Polettini E, Carlesimo OA, Calvieri S (1997) Relationship between cutaneous and pulmonary involvement in systemic sclerosis. J Rheumatol 24:81–85
Hansell DM, Wells AU, Padrey SPG, Müller NL (1996) Hypersensitivity pneumonitis: correlation of individual CT patterns with functional abnormalities. Radiology 199:123–128
Meyer CA, Pina JS, Taillon D, Godwin JD (1997) Inspiratory and expiratory high-resolution CT findings in a patient with Sjögren’s syndrome and cystic lung disease. AJR Am J Roentgenol 168:101–103
Worthy SA, Müller NL, Hartman TE, Swensen SJ, Padley SPG, Hansell DM (1997) Mosaic attenuation pattern on thin-section CT scans of the lung: differentiation among infiltrative lung, airway, and vascular disease as a cause. Radiology 205:465–470
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Quadrelli, S.A., Molinari, L., Ciallella, L.M. et al. Patterns of pulmonary function in smoking and nonsmoking patients with progressive systemic sclerosis. Rheumatol Int 29, 995–999 (2009). https://doi.org/10.1007/s00296-008-0824-0
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DOI: https://doi.org/10.1007/s00296-008-0824-0