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Pulmonary involvement in systemic sclerosis: an imaging study from kashmir.

Hassan I, Nisa N, Hamid M - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: The differences in these parameters between the two groups were statistically significant, while the differences for mean skin tethering index, mean disease duration and female/male sex ratio were statistically meaningless.Most common HRCT finding observed in the study was ground glass opacities (GGO) (9/20).Only 4 of total 9 patients who had only GGO in HRCT were symptomatic for respiratory involvement as compared to 100% (11/11) in the group who had HRCT findings other than or in addition to GGO.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, STD and Leprosy, Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India.

ABSTRACT

Background: Systemic sclerosis (SS) is a chronic, multisystem collagen vascular disorder of undefined etiology, whose prognosis and overall survival is determined by visceral especially the lung involvement.

Aim: To evaluate the pulmonary involvement in SS by imaging methods.

Materials and methods: Clinical examination, pulmonary function tests, chest X-ray and high resolution computed tomography (HRCT) scans were carried out in a series of 25 patients prospectively over a period of 3 years (2009-2011AD).

Results: Of the total 25 patients of the study, the group with abnormal HRCT chest (n = 20), 16 had clinical symptoms of respiratory involvement, only 7 had an abnormal chest X-ray and 15 had abnormal forced expiratory volume/forced vital capacity (FEV1/FVC) spirometric parameter. While the group with normal HRCT chest (n = 5), 1 had clinical symptoms of respiratory involvement and 4 had abnormal FEV1/FVC spirometric parameter. The differences in these parameters between the two groups were statistically significant, while the differences for mean skin tethering index, mean disease duration and female/male sex ratio were statistically meaningless. Most common HRCT finding observed in the study was ground glass opacities (GGO) (9/20). Only 4 of total 9 patients who had only GGO in HRCT were symptomatic for respiratory involvement as compared to 100% (11/11) in the group who had HRCT findings other than or in addition to GGO.

Conclusion: The HRCT outscores Chest X-ray in detecting early lung involvement in SS patients more so early in the course of the disease thereby underscoring its importance in identifying SS patients who will be potential candidates for early institution of therapy that might reverse/limit pulmonary involvement by the disease.

No MeSH data available.


Related in: MedlinePlus

Thickened interlobular septae with sub-pleural cystic areas. Interstitial pulmonary fibrosis. Honey-combing. Pleural effusion ill-defined sub-pleural nodules, thickening of interstitium in both lungs with cyst in left lung
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Figure 5: Thickened interlobular septae with sub-pleural cystic areas. Interstitial pulmonary fibrosis. Honey-combing. Pleural effusion ill-defined sub-pleural nodules, thickening of interstitium in both lungs with cyst in left lung

Mentions: Our study documented a solitary cyst in one lung of a patient [Figure 5]. Whether this cyst was present congenitally or developed during the course of SS remains to be elucidated. Our study also documented pneumothorax in one case [Figure 1]. Spontaneous pneumothorax has been reported, often, in association with subpleural blebs in the context of ILD. Interstitial fibrosis is not an essential underlying condition for the development of pneumomediastinum, as some cases with pneumomediastinum reported in the literature had no findings of ILD. Rupture of the alveoli and honeycomb cysts and subsequent air leakage into the surrounding interstitium could be regarded as a cause of pneumomediastinum in patients with pulmonary fibrosis.[10]


Pulmonary involvement in systemic sclerosis: an imaging study from kashmir.

Hassan I, Nisa N, Hamid M - Indian J Dermatol (2015 Jan-Feb)

Thickened interlobular septae with sub-pleural cystic areas. Interstitial pulmonary fibrosis. Honey-combing. Pleural effusion ill-defined sub-pleural nodules, thickening of interstitium in both lungs with cyst in left lung
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318021&req=5

Figure 5: Thickened interlobular septae with sub-pleural cystic areas. Interstitial pulmonary fibrosis. Honey-combing. Pleural effusion ill-defined sub-pleural nodules, thickening of interstitium in both lungs with cyst in left lung
Mentions: Our study documented a solitary cyst in one lung of a patient [Figure 5]. Whether this cyst was present congenitally or developed during the course of SS remains to be elucidated. Our study also documented pneumothorax in one case [Figure 1]. Spontaneous pneumothorax has been reported, often, in association with subpleural blebs in the context of ILD. Interstitial fibrosis is not an essential underlying condition for the development of pneumomediastinum, as some cases with pneumomediastinum reported in the literature had no findings of ILD. Rupture of the alveoli and honeycomb cysts and subsequent air leakage into the surrounding interstitium could be regarded as a cause of pneumomediastinum in patients with pulmonary fibrosis.[10]

Bottom Line: The differences in these parameters between the two groups were statistically significant, while the differences for mean skin tethering index, mean disease duration and female/male sex ratio were statistically meaningless.Most common HRCT finding observed in the study was ground glass opacities (GGO) (9/20).Only 4 of total 9 patients who had only GGO in HRCT were symptomatic for respiratory involvement as compared to 100% (11/11) in the group who had HRCT findings other than or in addition to GGO.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, STD and Leprosy, Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India.

ABSTRACT

Background: Systemic sclerosis (SS) is a chronic, multisystem collagen vascular disorder of undefined etiology, whose prognosis and overall survival is determined by visceral especially the lung involvement.

Aim: To evaluate the pulmonary involvement in SS by imaging methods.

Materials and methods: Clinical examination, pulmonary function tests, chest X-ray and high resolution computed tomography (HRCT) scans were carried out in a series of 25 patients prospectively over a period of 3 years (2009-2011AD).

Results: Of the total 25 patients of the study, the group with abnormal HRCT chest (n = 20), 16 had clinical symptoms of respiratory involvement, only 7 had an abnormal chest X-ray and 15 had abnormal forced expiratory volume/forced vital capacity (FEV1/FVC) spirometric parameter. While the group with normal HRCT chest (n = 5), 1 had clinical symptoms of respiratory involvement and 4 had abnormal FEV1/FVC spirometric parameter. The differences in these parameters between the two groups were statistically significant, while the differences for mean skin tethering index, mean disease duration and female/male sex ratio were statistically meaningless. Most common HRCT finding observed in the study was ground glass opacities (GGO) (9/20). Only 4 of total 9 patients who had only GGO in HRCT were symptomatic for respiratory involvement as compared to 100% (11/11) in the group who had HRCT findings other than or in addition to GGO.

Conclusion: The HRCT outscores Chest X-ray in detecting early lung involvement in SS patients more so early in the course of the disease thereby underscoring its importance in identifying SS patients who will be potential candidates for early institution of therapy that might reverse/limit pulmonary involvement by the disease.

No MeSH data available.


Related in: MedlinePlus