The researchers evaluated esophageal involvement and pulmonary manifestations in systemic sclerosis.
They assessed whether esophageal manometric motor disturbances are associated with abnormalities consistent with interstitial lung disease (ILD), on both pulmonary function tests (PFT) and high-resolution computerized tomography (HRCT) scans.
This was conducted during an initial evaluation and also at 2 years follow-up.
The findings from the study were reported in the August issue of Arthritis Care & Research.
Esophageal manometry, PFT, and HRCT scans were performed in 43 consecutive systemic sclerosis patients.
PFT and HRCT scan parameters were compared between patients with severe esophageal motor dysfunction (aperistalsis and decreased low esophageal sphincter pressure), patients with moderate dysfunction (hypoperistalsis), and patients without dysfunction on manometry.
| Frequency of ILD at 2 years follow-up:|
Severe esophageal motor disturbances 70%
Without motor disturbances 25%
| Arthritis Care & Research |
During the initial evaluation, patients with severe esophageal motor impairment exhibited significantly decreased median values of diffusing capacity for carbon monoxide (DLCO), at 68%. This was compared to those with moderate and without esophageal dysmotility (94% and 104%, respectively). They also exhibited a higher prevalence of evidence for ILD on HRCT scan (57%, 27%, and 18%, respectively).
At 2 years follow-up, patients with severe esophageal motor disturbances, compared with those without, had faster deterioration of DLCO median values (-16% vs +1%). In addition, they had higher frequency of ILD on HRCT scan (70% vs 25%).
Author Isabelle Marie, of the Centre Hospitalier Universitaire de Rouen-Boisguillaume, said on behalf of her colleagues, "Our series underscores a correlation between the degree of esophageal manometric motor disturbances, and evidence for ILD on PFT and HRCT scan in systemic sclerosis patients.
"This suggests that gastroesophageal reflux may be one of the contributing factors of ILD in systemic sclerosis.
"Our findings further indicate that patients with severe esophageal impairment may require closer follow-up of lung parameters.
"In turn, it suggests that aggressive therapy of gastroesophageal reflux should be initiated in these sclerosis patients, as it may result in decreased deterioration of pulmonary function," she concluded.