Pulmonary Involvement in Patients with Systemic Sclerosis

Abstract

Background: Systemic sclerosis is a multisystem autoimmune disease of unknown etiology. The pulmonary system is involved in Systemic sclerosis and causes a significant increase in morbidity and mortality. This study aimed to assess the extent of pulmonary system involvement in patient with systemic sclerosis. Methods: This study was a case control study, done on thirty patients with systemic sclerosis and twenty age and sex matched as a control group . All patients included in the study were subjected to the following: Full history, evaluation of skin involvement using modified Rodnan skin thickness score. Investigations including: Pulmonary function test, radiological examination (plain chest X-ray and high-resolution computed tomograghy. Results: predominance of females among patients. 53.33% had limited scleroderma. Modified Rodnen Score ranged from 12 to 35 with mean of 21.03 ± 7.04. Regarding skin changes of systemic sclerosis patients, skin thickness (60%), hyper or hypopigmentation (100%), ischemic ulcers (30%) and subcutaneous calcinosis (20%). A higher frequency of ILD was observed among SSc patients included in this study. The most common patterns in the HRCT in the current study were ground-glass appearance, followed by, honeycombing. Pulmonary hypertension occurred in 30% patients There were highly statistically significant differences (p < 0.001) between cases and the control group regarding PFTs and the severity of restrictive pattern. Conclusion: Pulmonary manifestations are very common in SSc in the form of ILD and PH. PFTs are cornerstone in the evaluation of dyspnea and for detection of pulmonary involvement in SSc patients.