Skip to main content
Log in

Patterns of pulmonary function in smoking and nonsmoking patients with progressive systemic sclerosis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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

    Article  PubMed  CAS  Google Scholar 

  2. Medsger TA Jr (1987) D-penicillamine treatment of lung involvement in patients with systemic sclerosis (scleroderma). Arthritis Rheum 30:832–834

    Article  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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

    Google Scholar 

  5. 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

    Article  CAS  Google Scholar 

  6. O’Donnell DE (1998) Physiology of interstitial lung disease. In: Schwarz M, King T Jr, Hamilton ON (eds) interstitial lung disease. Dekker, New York

    Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed  CAS  Google Scholar 

  9. 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

    PubMed  CAS  Google Scholar 

  10. 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

    Article  Google Scholar 

  11. Quadrelli S, Bosio M, Salvado A, Chertcoff J (2007) Valor de la espirometria para el diagnostico de restricción pulmonar. Medicina 67:685–690

    PubMed  Google Scholar 

  12. 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

  13. Bland M (2000) An introduction to medical statistics (Oxford Medical Publications). Oxford University Press, New York, p 210

    Google Scholar 

  14. Steen V, Owens G, Fino G, Rodnan G, Medsger T (1985) Pulmonary involvement in systemic sclerosis (scleroderma). Arthritis Rheum 28:759–767

    Article  PubMed  CAS  Google Scholar 

  15. Silver R, Miller K (1990) Lung involvement in systemic sclerosis. Rheum Dis Clin North Am 16:199–216

    PubMed  CAS  Google Scholar 

  16. 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

    CAS  Google Scholar 

  17. 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

    PubMed  CAS  Google Scholar 

  18. 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

    Article  PubMed  CAS  Google Scholar 

  19. Schneider PD, Wise RA, Hochberg MC, Wigley FM (1982) Serial pulmonary function in systemic sclerosis. Am J Med 73:385–394

    Article  PubMed  CAS  Google Scholar 

  20. 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

    PubMed  CAS  Google Scholar 

  21. 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

    Article  Google Scholar 

  22. Wilcox AG (2000) Small airway involvement in interstitial lung disease: radiologic evidence. Curr Opin Pulm Med 6:399–403

    Article  PubMed  CAS  Google Scholar 

  23. 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

    Article  PubMed  CAS  Google Scholar 

  24. 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

    Article  CAS  Google Scholar 

  25. Kim DS (2006) Interstitial lung disease in rheumatoid arthritis: recent advances. Curr Opin Pulm Med 12:346–353

    Article  PubMed  Google Scholar 

  26. 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

    Article  PubMed  Google Scholar 

  27. 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

    Article  PubMed  CAS  Google Scholar 

  28. King TE Jr (1993) Respiratory bronchiolitis-associated interstitial lung disease. Clin Chest Med 14:693–698

    PubMed  Google Scholar 

  29. Johkoh T, Muller NL, Pickford HA et al (1999) Lymphocytic interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 212:567–572

    PubMed  CAS  Google Scholar 

  30. 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

    PubMed  Google Scholar 

  31. Newball HH, Brahim SA (1977) Chronic obstructive airway disease in patients with Sjögren’s syndrome. Am Rev Respir Dis 115:295–304

    PubMed  CAS  Google Scholar 

  32. 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

    Article  PubMed  CAS  Google Scholar 

  33. 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

    PubMed  CAS  Google Scholar 

  34. 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

    Article  PubMed  CAS  Google Scholar 

  35. 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

    PubMed  CAS  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. 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

    Article  PubMed  CAS  Google Scholar 

  38. 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

    Article  PubMed  CAS  Google Scholar 

  39. 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

    PubMed  CAS  Google Scholar 

  40. Hansell DM, Wells AU, Padrey SPG, Müller NL (1996) Hypersensitivity pneumonitis: correlation of individual CT patterns with functional abnormalities. Radiology 199:123–128

    PubMed  CAS  Google Scholar 

  41. 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

    PubMed  CAS  Google Scholar 

  42. 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

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luciana Molinari.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-008-0824-0

Keywords

Navigation