Thin-section chest CT findings of primary Sjögren's syndrome: correlation with pulmonary function

Abstract

The purpose of this study was to describe thin-section CT findings of lung involvement in patients with primary Sjögren's syndrome (PSS), and to correlate them with pulmonary function tests (PFT). The chest thin-section CT examinations of 35 patients with proven diagnosis of PSS and respiratory symptoms were retrospectively assessed by two observers, in a first step independently with interobserver evaluation, and in a second step in consensus. The extent of the most frequent CT findings was scored. Correlation was made with PFT in 31 of these patients. Three main CT patterns were identified with good interobserver agreement (kappa coefficient 0.71): 19 of 35 (54%) large and/or small airways disease; 7 of 35 (20%) interstitial lung fibrosis (ILF); and 5 of 35 (14%) suggestive of lymphocytic interstitial pneumonia (LIP). The CT scans were normal in 2 patients (6%) and showed only dilatation of pulmonary vessels due to pulmonary arterial hypertension in two others (6%). Airway disease patients had predominantly obstructive profiles (mean FEV(1)/FVC ratio 69.7+/-12.7%, mean MEF(25) 50.1+/-22.9%), whereas patients with ILF and LIP had predominantly restrictive profiles and/or a decreased diffusing lung capacity (mean TLC 87.0+/-26.0 and 64.6+/-18.6%, mean DL(CO) 57.4+/-21.2 and 52.0+/-8.0%). Significant correlation ( p<0.01) was found between the scores of ground-glass attenuation and TLC ( r=-0.84) and DL(CO) ( r=-0.70) and between the score of air trapping and FEV1 ( r=-1.0). In patients with PSS and respiratory symptoms, thin-section CT may provide characterization of lung involvement which correlates with pulmonary function.

Small airways diseases, excluding asthma and COPD: an overview

“…Both follicular bronchiolitis and constrictive bronchiolitis may be encountered in subjects with connective tissue diseases and may even coexist in the same patient [41,44]. CT scan findings in Sjö gren's syndrome and in rheumatoid arthritis have been the subject of many studies [44][45][46][47][48][49][50][51][52][53][54], and are characterised by usual signs of small airways abnormalities, including mosaic attenuation on inspiratory CT, air trapping on expiratory CT, ground-glass opacities, and centrilobular nodules eventually with tree-in-bud pattern (especially in cellular bronchiolitis) or distension (especially in constrictive bronchiolitis). CT scans may have better sensitivity than pulmonary function tests in rheumatoid arthritis [52].…”

Successful treatment of primary Sjogren’s syndrome complicated with primary biliary cirrhosis and lung involvement

“…However, recent reports suggest that the frequency of LIP may be higher in SS. Taouli et al (1) found that 31 of 35 SS patients have lung involvement on chest CT, and 5 of those 31 were diagnosed as LIP. The main HRCT findings in LIP are ground-glass attenuation, poorly defined centrilobular nodules, thickening of bronchovascular bundles, and lymph node enlargement (1).…”

“…Taouli et al (1) found that 31 of 35 SS patients have lung involvement on chest CT, and 5 of those 31 were diagnosed as LIP. The main HRCT findings in LIP are ground-glass attenuation, poorly defined centrilobular nodules, thickening of bronchovascular bundles, and lymph node enlargement (1). Pulmonary biopsy may be required to exclude differential diagnoses including usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) with fibrosis.…”

Interstitial Lung Diseases in Rheumatology Practice: A Single Center Experience

“…The evaluation of the radiological studies was performed according to the definition as reported previously (21).…”