Lung fibrosis is uncommon in primary Sjögren's disease: A retrospective analysis of computed tomography features in 77 patients - 23/01/24
Highlights |
• | More than half of patients with primary Sjögren's disease and no respiratory symptoms harbor lung abnormalities on computed tomography. |
• | Air cysts and mosaic attenuation are the predominant lung abnormalities on computed tomography in patients with primary Sjögren's disease. |
• | Lung fibrosis is an uncommon computed tomography finding in patients with primary Sjögren's disease with a prevalence of 6%. |
Abstract |
Purpose |
The purpose of this study was to describe lung abnormalities observed on computed tomography (CT) in patients meeting the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for primary Sjögren's disease (pSD).
Materials and methods |
All patients with pSD seen between January 2009 and December 2020 in the day care centre of our National Reference Center for rare systemic autoimmune diseases, who had at least one chest CT examination available for review and for whom the cumulative EULAR Sjögren's Syndrome Disease Activity Index (cumESSDAI) could be calculated were retrospectively evaluated. CT examinations were reviewed, together with clinical symptoms and pulmonary functional results.
Results |
Seventy-seven patients (73 women, four men) with a median age of 51 years at pSD diagnosis (age range: 17–79 years), a median follow-up time of 6 years and a median cumESSDAI of 7 were included. Sixty-six patients (86%) had anti-SSA antibodies. Thirty-three patients (33/77; 43%) had respiratory symptoms, without significant alteration in pulmonary function tests. Forty patients (40/77; 52%) had abnormal lung CT findings of whom almost half of them had no respiratory symptoms. Abnormalities on chest CT were more frequently observed in patients with anti-SSA positivity and a history of lymphoma. Air cysts (28/77; 36%) and mosaic perfusion (35/77; 35%) were the predominant abnormalities, whereas lung fibrosis was observed in five patients (5/77; 6%).
Conclusion |
More than half of patients with pSD have abnormal CT findings, mainly air cysts and mosaic perfusion, indicative of small airways disease, whereas lung fibrosis is rare, observed in less than 10% of such patients.
El texto completo de este artículo está disponible en PDF.Keywords : Bronchiolitis, Computed tomography, Diffuse parenchymal lung disease, Pulmonary fibrosis, Sjögren's disease
Abbreviations : ACR/EULAR, CT, CTDIvol, CTD, cumESSDAI, DLCO, FVC, ICD-10, ILD, PFTs, pSD, RNP, SD, SSA, TLC
Esquema
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