Systemic sclerosis: correlation between lung abnormalities on high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs)

Ibrahim, Iman Mohamed Hamdy; Gamal, Sherif Mohamed; Salama, Adham Mamdouh; Khairy, Mostafa Ahmed

doi:10.1186/s43055-020-00220-3

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…2 Of three patients who could not perform PFT, two had a UIP pattern with honey-combing suggesting severe disease associated with honey-combing and coarse reticular fibrosis. This was in agreement with the observations of Ooi et al 7 Traction bronchiectasis was seen in 14 (38.8%) cases in our study, in contrast with Ibrahim et al 23 . In almost all the patients in our study, lower lobe predominance of ILD was observed.…”

Section: Discussionsupporting

confidence: 94%

“…Similar observations, were reported by other workers. 23,25 Mediastinal lymphadenopathy was found in seven (19.4%) cases in our study while Bhalla et al 26 and Ibrahim et al 23 observed in 60% and 76.7% of their patients, respectively.…”

Section: Discussionmentioning

confidence: 38%

“…This was in agreement with the results of earlier studies. 7,23 Most common extra-pulmonary finding in our study was oesophageal dilatation. Oesophagus was considered as dilated when infra-aortic oesophagus measured ≥9mm in coronal diameter.…”

Section: Discussionmentioning

confidence: 50%

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Correlation of HRCT Scoring System with PFT Parameters in Interstitial Lung Disease Associated with Systemic Sclerosis Patients

Sahani¹,

Singh²,

Chumber³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Objectives. Interstitial lung disease (ILD) with features of pulmonary fibrosis and honey-combing is a significant cause of morbidity and mortality in patients with systemic sclerosis (SSc). High resolution computed tomography (HRCT) is the established non-invasive gold standard technique for the diagnosis of SSc related ILD. The present study was designed to characterise HRCT features of ILD in SSc and to correlate pulmonary function test (PFT) parameters with HRCT semi-quantitative scores.Methods. This is an observational, cross-sectional study including 36 patients of SSc who underwent HRCT chest. All the patients were females. Severity and extent were assessed using four HRCT features: ground-glass opacity (GGO), mixed GGO and reticular opacity, reticular fibrosis and honey-combing. Thirtythree patients were able to perform PFT. Total HRCT score, inflammatory index and fibrosis index were correlated with PFT parameters.Results. Interstitial lung disease was found in 33 patients (91.6%), 24 patients (66.6%) had mixed GGO along with reticular inter-lobular septal thickening. Majority of the patients (64%) had non-specific interstitial pneumonia (NSIP) pattern. Usual interstitial pneumonia (UIP) pattern was seen in 25% of the cases. One patient had overlapping features of both UIP and organising pneumonia. There was predominant lower lobe involvement. Among the 33 patients who were able to perform PFT, 85% had abnormal results (predicted forced vital capacity [FVC]<80%). Total HRCT score showed significant negative correlation with PFT parameters --FVC (r=-0.48, P=0.004) and forced expiratory volume in one second (FEV 1 ) (r=-0.28, P=0.1), respectively. The ratio of FEV 1 and FVC had significant positive correlation with total HRCT score (r=0.5, P=0.002). Inflammatory index and fibrosis index had significant negative correlation with predicted FVC% (P<0.05).Conclusions. Mixed pattern (GGO and reticular opacity) was the most common HRCT finding. HRCT semi-quantitative scoring system is sensitive in assessing the severity and extent of ILD qualitatively and quantitatively in SSc patients.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 38%

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Correlation of HRCT Scoring System with PFT Parameters in Interstitial Lung Disease Associated with Systemic Sclerosis Patients

Sahani¹,

Singh²,

Chumber³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Progressive pulmonary fibrosis: an expert group consensus statement

Rajan

Cottin

Dhar³

et al. 2022

Eur Respir J

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This expert group consensus statement emphasises the need for standardising the definition of progressive fibrosing interstitial lung diseases (F-ILDs), with an accurate initial diagnosis being of paramount importance in ensuring appropriate initial management. Equally, case-by-case decisions on monitoring and management are essential, given the varying presentations of F-ILDs and the varying rates of progression. The value of diagnostic tests in risk stratification at presentation and, separately, the importance of a logical monitoring strategy, tailored to manage the risk of progression, are also stressed. The term “progressive pulmonary fibrosis” (PPF) exactly describes the entity that clinicians often face in practice. The importance of using antifibrotic therapy early in PPF (once initial management has failed to prevent progression) is increasingly supported by evidence. Artificial intelligence software for high-resolution computed tomography analysis, although an exciting tool for the future, awaits validation. Guidance is provided on pulmonary rehabilitation, oxygen and the use of non-invasive ventilation focused specifically on the needs of ILD patients with progressive disease. PPF should be differentiated from acute deterioration due to drug-induced lung toxicity or other forms of acute exacerbations. Referral criteria for a lung transplant are discussed and applied to patient needs in severe diseases where transplantation is not realistic, either due to access limitations or transplantation contraindications. In conclusion, expert group consensus guidance is provided on the diagnosis, treatment and monitoring of F-ILDs with specific focus on the recognition of PPF and the management of pulmonary fibrosis progressing despite initial management.

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Systemic sclerosis: correlation between lung abnormalities on high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs)

Cited by 2 publications

References 28 publications

Correlation of HRCT Scoring System with PFT Parameters in Interstitial Lung Disease Associated with Systemic Sclerosis Patients

Correlation of HRCT Scoring System with PFT Parameters in Interstitial Lung Disease Associated with Systemic Sclerosis Patients

Progressive pulmonary fibrosis: an expert group consensus statement

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