Pulmonary Involvement in Sjögren’s Syndrome

Bariffi, F; Pesci, Alberto; Bertorelli, Giuseppina; Manganelli, P; Ambanelli, U

doi:10.1159/000194674

Cited by 30 publications

(14 citation statements)

References 2 publications

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“…Most of these studies [3,6,8,11] have shown signs of restrictive pulmonary disease in accordance with our previous resuits [1]. Other studies [4,5] have shown signs of obstructive ventilatory disease.…”

Section: Discussionsupporting

confidence: 85%

“…These pulmonary abnormalities may explain the altered pulmonary function parameters often found in patients with primary SS. Reduced diffusing capacity is the most prominent lung function abnormality reported in patients with primary SS [1,3,8,10]. Some authors [3,8,10] have demonstrated the presence of a restrictive lung disease affecting above all the small airways.…”

Section: Introductionmentioning

confidence: 99%

“…Reduced diffusing capacity is the most prominent lung function abnormality reported in patients with primary SS [1,3,8,10]. Some authors [3,8,10] have demonstrated the presence of a restrictive lung disease affecting above all the small airways. Segal et al examined 20 patients with SS and concluded that airway obstruction was the most common abnormality [4].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 1990

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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.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 1990

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“…A variety of pulmonary abnormalities, including ILD, airways disease, and vascular disease, are associated with SS [7][8][9][10][11][12][13][14][15][16][17][18][19] (see the comprehensive review by Quismorio 19 ). The frequency of specific pulmonary abnormalities associated with pSS in published studies [7][8][9][10][11][12][13][14][15][16][17][18][19] is variable.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of specific pulmonary abnormalities associated with pSS in published studies [7][8][9][10][11][12][13][14][15][16][17][18][19] is variable. This variability is due to several factors, including the lack of uniform diagnostic criteria for SS, differing modalities to define pulmonary abnormalities, the variability in the number of current or former smokers and the possible presence of smoking-related lung disease, and the inclusion of patients with pSS or secondary SS.…”

Section: Discussionmentioning

confidence: 99%

Minor Salivary Gland Biopsy To Detect Primary Sjögren Syndrome in Patients With Interstitial Lung Disease

Fischer

Swigris

Bois

et al. 2009

Chest

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Purpose: To describe a cohort of patients who presented with interstitial lung disease (ILD) of unknown cause, features of primary Sjö gren syndrome (pSS), and a positive minor salivary gland biopsy (MSGB). Methods: Thirty-eight patients with ILD evaluated at our center underwent an MSGB to confirm a diagnosis of pSS. All of the samples were reviewed by pathologists experienced in the evaluation of salivary gland histology. We defined a positive MSGB finding as a lymphocyte focus score of >1. Results: At presentation, all patients had ILD, and symptoms of cough and dyspnea. None had a definable connective tissue disease (CTD) or known cause for their ILD. Thirteen patients (34%) had positive MSGB findings. Of these, the median age was 61 years (age range, 33 to 75 years); 7 patients (54%) were women; 8 patients (62%) had a smoking history; and 10 patients (77%) had sicca symptoms. In all patients, a thoracic high-resolution CT scan evaluation demonstrated bibasilar, peripheral-predominant, ground-glass, and reticular opacities. Four patients (31%) were negative for both antinuclear autoantibody (ANA) and rheumatoid factor (RF) autoantibody, and three patients (23%) were negative for ANA, RF, Sjö gren syndrome (SS)-A, and SS-B autoantibodies. No patients experienced any complications from the MSGB. The identification of underlying pSS did not affect the management of ILD in these patients. Conclusions: Confirming a diagnosis of pSS-related ILD by performing MSGB allows for a more precise CTD classification. This study provides evidence that CTD may exist subclinically, and longitudinal studies are needed to determine whether identifying occult CTD impacts on management, longitudinal changes in lung function, or survival.

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Subclinical lung inflammation in primary sjögren's syndrome. relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease

Hatron

Wallaert

Gosset

et al. 1987

Arthritis & Rheumatism

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To directly evaluate whether a subclinical alveolar inflammation is associated with primary Sjögren's syndrome (SS), we evaluated the distribution of cells obtained by bronchoalveolar lavage (BAL) from the lower respiratory tract in 29 patients who had primary SS, but who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. There was no difference in total cell counts of specimens from patients versus those of controls. An abnormal differential cell count was noted in 16 patients (55%). Two patterns of alveolitis were observed: a pure lymphocyte alveolitis (>18% lymphocytes, present in 11 patients) and a neutrophil alveolitis (>4% neutrophils, present in 5 patients). There was associated lymphocytosis in 4 of the patients with neutrophil alveolitis. All patients had normal results on pulmonary function tests. Patients with abnormal BAL findings showed clinical and biologic indexes of more severe disease than did those with normal BAL results, as demonstrated by greater extraglandular extension of the disease, higher mean values of serum gamma globulins and serum β2‐microglobulin, and higher prevalence of rheumatoid factor and of antinuclear antibody. Thus, our data demonstrate that BAL permitted the detection of subclinical inflammatory alveolitis in 55% of our patients with primary SS. A long‐term followup is required to determine whether these patients will develop obvious pulmonary involvement.

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Pulmonary Involvement in Sjögren’s Syndrome

Cited by 30 publications

References 2 publications

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

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

Minor Salivary Gland Biopsy To Detect Primary Sjögren Syndrome in Patients With Interstitial Lung Disease

Subclinical lung inflammation in primary sjögren's syndrome. relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease

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