Frequent development of chronic obstructive pulmonary disease in primary SS--results of a longitudinal follow-up

Abstract

The pSS patients showed signs of both obstructive and restrictive pulmonary disease and COPD commonly developed during follow-up. Respiratory symptoms and radiographic abnormalities were common but poorly associated with PFT in pSS patients.

The forced oscillation technique is a sensitive method for detecting obstructive airway disease in patients with primary Sjögren’s syndrome

“…The lack of association between pulmonary function, respiratory symptoms, and signs of inflammation is in accord with previous reports (2,3,6).…”

“…As the participants in the study were matched for other factors associated with airway obstruction, the findings of obstruction seem to be due to the disease per se, especially considering that similar FOT signs were found in never-smoking pSS patients. Indeed, signs of both obstructive and restrictive disease have previously been reported in non-smoking pSS patients and in pSS patients with low tobacco consumption (2)(3)(4). Mononuclear cell infiltration of the small airway wall, leading to anatomical obstruction and the production of cytokines affecting the lung physiology, has been suggested to explain the physiological abnormalities observed in pSS patients, along with mucosal dryness in the airways, leading to decreased mucociliary clearance (1,2).…”

“…Pulmonary involvement in pSS tends to be pleomorphic and may affect airways and lung parenchyma resulting in both obstructive and interstitial lung disease. Although both prevalence and type of pulmonary involvement in pSS differ between studies, several report that small airway obstruction is common in pSS (1)(2)(3)(4)(5)(6)(7). In a recent longitudinal study, pSS patients were frequently found to develop chronic obstructive pulmonary disease (COPD), even though the vast majority of the patients had not been smoking during followup (3).…”

Pulmonary manifestations of Sjögren's syndrome

“…The frequency of bronchiectasis in Sjögren's syndrome patients, as assessed by CT, varies from 7% to 54% [43,49,56,59,83,84]. In most cases, it concerns cylindrical bronchiectasis.…”

Pulmonary Manifestations of Sjögren’s Syndrome

“…In a cohort from Sweden, 37% of primary SS patients fulfilled COPD criteria over 11 years of followup (21). COPD was 5 times more prevalent among ever smokers, but even the prevalence among non-smokers was unexpectedly high.…”