Abstract
Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.
Highlights
Lung is one of main involved organs in diffuse connective tissue diseases (CTDs)
Based on high-resolution computerized tomography (HRCT), a patient was classified into interstitial lung disease (ILD) group (CTD+ILD) or non-ILD group (CTD-ILD)
Little is known about how the manifestations of lung HRCT and pulmonary function tests (PFT) vary among different ILDs associated with those CTDs (CTD+ILD) and what factors are related to those ILDs
Summary
Lung is one of main involved organs in diffuse connective tissue diseases (CTDs). As the use of high-resolution computerized tomography (HRCT) and pulmonary function tests (PFT) has become more frequent in clinics, CTDs, such as rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) have increasingly been found with interstitial lung disease (ILD) [1]. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and serum ferritin (SF) levels are higher in patients with CTD+ILD than patients with CTD but without ILD (CTD-ILD) [2] [3] [4]. These changes have been associated with the prognosis of patients with CTD+LD [2] [3] [4]. We compared the incidences and the differences of ILDs in HRCT and PFT among patients with different CTDs, and analyzed the correlations between ILDs and changes in inflammatory markers and auto-antibody levels
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