Background Pulmonary involvement is common in primary Sjögren’s syndrome (pSS). Characteristics of pulmonary function and computed tomography imaging for pSS-associated lung disease which are feasible in clinic were less studied. In additon, there is limited information regarding the risk factors in the published literature dealing with pulmonary manifestations of pSS.
Objectives We described the radiologic and pulmonary functional characteristics for pulmonary manifestation and detected the risk factors of lung involvement in a large cohort of pSS patients.
Methods A total of 112 hospitalized patients with pSS-associated lung disease were retrospectively analyzed and recruited as study group. The high-resolution computed tomography (HRCT), pulmonary function test (PFT) and laboratory tests were evaluated. HRCT were re-evaluated by two experienced chest radiologists according to the classification of CT patterns described in the American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. Seventy one patients without any organ damage were enrolled as control group to explore risk factors for lung involvement in pSS patients.
Results Among the 112 pSS patients with lung involvement, 102 (91.10%) were female. The mean age was 61.74±10.24 years old. The disease duration was 60 months (12.00 to 147.00 months). Results from descriptive study: Lung involvement affected pulmonary lobes broadly, especially lower lobes. The total HRCT score was 9.71±4.77. The HRCT abnormalities involved many types, and the most frequent HRCT findings were linear opacities (94.2%) and ground-glass attenuation (87.0%). Impaired diffusing capacity was common (74.3%) and severe (predicted value of TLCO was 57.52±21.23%). Among the 36 patients taking artery blood gas (ABG), 20 patients had hypoxia and 7 had Type 1 respiratory failure. Results from case control study: Compared with the control group, the mean age and levels of RF, CRP, ESR were significant higher in study group, whereas, anti-SSA, anti-SSB and AFP were less common. Age and anti-SSA were retained as independent correlates after adjusting for all the factors with significant difference (P value for Age was 0.000; SSA 0.012).
Conclusions Lung involvement is a severe complication for pSS patients. Age and anti-SSA are independent correlated with pulmonary complication in pSS patients.
References Ito I, Nagai S, Kitaichi M, et al. Pulmonary manifestations of primary Sjogren’s syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med. 2005; 171: 632-8.
Yazisiz, V. et al. Lung involvement in patients with primary Sjogren’s syndrome: what are the predictors? Rheumatol Int (2009).
Disclosure of Interest None Declared