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AB1241 Interstitial lung disease ultrasound evaluation in churg-strauss patients
  1. A. Delle Sedie1,
  2. C. Baldini1,
  3. M. Latorre2,
  4. P. Pepe1,
  5. L. Riente1,
  6. P.L. Paggiaro2,
  7. S. Bombardieri1
  1. 1Internal Medicine, Rheumatology Unit
  2. 2Pneumology Unit, University of Pisa, Pisa, Italy

Abstract

Background Churg Strauss syndrome (CSS) is a systemic vasculitis characterized by asthma, eosinophilia and lung infiltrates. Ultrasound (US) has recently been used to study the lung and specific findings (called B-lines) have been related to the thicknening of the interlobular septa, making it possible to assess interstitial lung disease. The B-lines have also been related to a decrease of carbon monoxide diffusing capacity (DLCO) values[1].

Objectives The aim of the study was to assess the usefulness of US in the assessment of lung involvement in a group of CSS patients.

Methods A group of consecutive outpatients affected by CSS (according to ACR criteria) were enrolled. Asthma severity was evaluated according to FEV1, FEV1/SVC, GINA guidelines, asthma control test. In all the cases, chest X-rays and DLCO were performed. Systemic clinical and serological disease manifestations, BVAS and VDI were assessed. Lung US was performed blindly by the same operator with a Toshiba Powervision 6000 machine and a 6 MHz linear probe, using a scanning protocol used in the previous studies [2]. Total score was given by the sum of the B-lines in each intercostal space.

Results Ninenteen patients (mean age 55.3±14.5 years, F:M=7:12, mean disease duration 6.9±7.1 years, ANCA positivity 32%) were enrolled. At study entry, all the patients were in clinical remission; asthma was poorly or partially controlled in 4 and 8 patients, respectively. Two patients showed persistent interstitial involvement on X-ray, which was confirmed on HRCT scan. Inhaled glucocorticoid (GC) and long-acting beta2-agonist were taken by all the patients. Fifteen subjects were on maintenance therapy with low-doses oral GC associated with methotrexate in 6/15 cases. B-lines total score was negative (<12) (2) in 15/19 patients (mean 4.1±3.4). A positive B-line total score was detected in 4/19 subjects (mean 38±32.3) including the 2 HRCT positive cases.

Conclusions These preliminary results emphasise the role of US in the assessment of lung interstitial involvement in CSS patients with the advantages of having a good prediction of disease damage and of the use of a radiation-free bed-side imaging technique.

  1. Gargani L, Doveri M, D’Errico L et al. Rheumatology (Oxford). 2009;48:1382-7

  2. Delle Sedie A, Doveri M, Frassi F et al. Clin Exp Rheumatol 2010;28(5 Suppl 62):S54

Disclosure of Interest None Declared

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