Background Pulmonary involvement is frequent and serious organ manifestation of connective tissue diseases. Diagnosis needs to use the set of examination procedures. Some of these methods represent stress for patient, others are expensive for repetitive use. Method of induced sputum is simple, non-invasive, reproducible method, measuring intensity of inflammatory reaction in bronchial asthma and interstitial lung disease patients. We have found increased frequency of pulmonary involvement in patients with leucocyte predominance in induced sputum.

Objectives Aim of current study was to estimate predictive value of cytology of induced sputum for progressive pulmonary involvement in patients with connective tissue diseases.

Methods Forty-five patients with established diagnosis of connective tissue disease (SLE, PSS, PM/DM), were examined for pulmonary involvement (X-ray, spirometry, diffusion lung capacity, high resolution CT scan, event.bronchoscopy with BAL). Induced sputum was obtained after inhalation of 5 ml of 3 percent solution of natrium chloride by ultrasonographic nebuliser. The induced sputum was cultivated, cytological and immunophenotypisation examinations were made. Pulmonary function tests and induced sputum examinations were repeatedly done after 9–12 moths.

Results We have detected progression of pulmonary involvement in 16 patients Cytological features of leucocyte predominance were found in 12 of them. In 29 non-progressive patients was leucocyte predominance found in only six cases. Respiratory infection was excluded.

Conclusion Method of induced sputum seems, after thoroughgoing appreciation, to be the interesting possibility of simple, non-invasive method for screening of pulmonary involvement progression in patients, suffering by connective tissue diseases.

References

1. Olivieri D, DIppolito R, Chetta A. Induced sputum: diagnostic value in interstitial lung disease. Curr Opin Pulm Med. 2000;6(5):411–14

2. Bradna P, Parakova Z, Kral B, Hrncir Z, et al. Method of induced sputum in screening of pulmonary involvement in connective tissue diseases. Rheumatologia 2000;14(2):91