A follow-up study of pulmonary function in patients with primary Sjögren's syndrome

Abstract

Twenty-seven patients (25 women, 2 men) with primary Sjögren's syndrome, previously reported to have reduced pulmonary diffusing capacities were reexamined in a 7-year follow-up in order to evaluate longitudinal alterations in pulmonary function. Primary Sjögren's syndrome was diagnosed according to the Copenhagen criteria. The present examination revealed normal and unchanged values for vital capacity, forced expiratory volume in 1 s, maximal expiratory flow at 50% of expired vital capacity (MEF50), and diffusing capacity per liter alveolar volume. Total diffusing capacity (P less than 0.01) and MEF75 (P less than 0.05), were, however, significantly reduced compared with the predicted values, indicating pulmonary involvement primarily affecting the small airways. The longitudinal examination, furthermore, showed increasing values for total diffusing capacity (P less than 0.02), diffusing capacity per liter alveolar volume (P less than 0.001), and MEF75 (P less than 0.02), suggesting an improvement in lung status in the course of time. No correlation was found between MEF75 and diffusing capacities, nor between alterations in pulmonary function and complaints of dyspnoea, tiredness, cough, expectoration, tobacco smoking, or medical treatment with bromhexine, glucocorticosteroids, essential fatty acids, or nonsteroid antiinflammatory drugs.

The forced oscillation technique is a sensitive method for detecting obstructive airway disease in patients with primary Sjögren’s syndrome

“…The lack of association between pulmonary function, respiratory symptoms, and signs of inflammation is in accord with previous reports (2,3,6).…”

“…Pulmonary involvement in pSS tends to be pleomorphic and may affect airways and lung parenchyma resulting in both obstructive and interstitial lung disease. Although both prevalence and type of pulmonary involvement in pSS differ between studies, several report that small airway obstruction is common in pSS (1)(2)(3)(4)(5)(6)(7). In a recent longitudinal study, pSS patients were frequently found to develop chronic obstructive pulmonary disease (COPD), even though the vast majority of the patients had not been smoking during followup (3).…”

Ten year follow up of pulmonary function in patients with primary Sjogren's syndrome

“…This improvement was seen both in patients treated with oral corticosteroids, where there was radiological evidence of interstitial lung disease, and in those where there was no therapeutic intervention. The improvement in lung function found by Linstow et al 6 was also independent of treatment. We have recently reported14a reduction towards normal in serum IgG levels in patients with primary SS followed up for 10 years, again in the absence of treatment, suggesting a reduction in disease activity.…”

“…Few longitudinal studies have been undertaken and their results are conflicting. Linstow et al detected no significant change in the pulmonary function of 27 patients over seven years,6 whereas we have previously reported a significant deterioration in lung function of 30 patients with primary SS over a follow up period of four years 7. We have now followed up this cohort for 10 years and have examined serological variables which might predict poor outcome.…”

Pulmonary Manifestations of Sjögren’s Syndrome

“…Primary SS patients had significantly decreased VC, TLC, FEV 1 , FEV 1 /VC and DL CO while the RV was increased in comparison with expected values. Respiratory symptoms, radiological abnormalities, and inflammatory and serological features of disease had no association with PFT variables, although in previous studies, an association was shown between PFT variables and anti-SSA antibodies (22), focal sialadenitis (22), hypergammaglobulinaemia, and β 2 -microglobulin (23). …”