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Oesophageal dilatation on HRCT-scan of the lungs as a sign of scleroderma
  1. Madelon C. Vonk (m.vonk{at}reuma.umcn.nl)
  1. Radboud University Nijmegen Medical Centre, Netherlands
    1. Lya E. van Die
    1. Radboud University Nijmegen Medical Centre, Netherlands
      1. Miranda M. Snoeren
      1. Radboud University Nijmegen Medical Centre, Netherlands
        1. Kavish J. Bhansing
        1. Radboud University Nijmegen Medical Centre, Netherlands
          1. Piet L.C.M. van Riel
          1. Radboud University Nijmegen Medical Centre, Netherlands
            1. Jaap Fransen
            1. Radboud University Nijmegen Medical Centre, Netherlands
              1. Frank H.J. van den Hoogen
              1. Sint Maartenskliniek Nijmegen, Netherlands

                Abstract

                Background: Systemic sclerosis (SSc) is a generalised autoimmune disease, which causes morbidity and reduced life expectancy. Recently evidence has been accumulating that immunosuppressive treatment in an early stage of the disease could improve survival, enhancing the need for early diagnosis and regular evaluation of organ involvement. Among others, a High Resolution Computer Tomography scan (HRCT-scan) of the chest is performed for the assessment of pulmonary involvement in SSc. The objective of this study is to evaluate the predictive value of oesophageal dilatation on the HRCT-scan for the diagnosis of SSc.

                Methods: In total 105 consecutive scleroderma patients and 107 consecutive controls were included in this study. The first available scan for each patient and control was evaluated in random order and blinded for the diagnosis, by two independent radiologists, for oesophageal dilatation and interstitial lung disease.

                Results: The positive predictive value of oesophageal dilatation for the diagnosis of SSc was 83%. No significant correlation of oesophageal dilatation and interstitial lungdisease was found in the scleroderma patients or controls.

                Conclusion: Oesophageal dilatation as visible on an HRCT-scan of the chest may alert physicians to look for other signs or symptoms of SSc in these patients, enabling early diagnosis and specific treatment.

                • HRCT-scan
                • interstitial lung disease
                • oesophageal dilatation
                • systemic sclerosis

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