Esophageal hypomotility in systemic sclerosis:Close relationship with pulmonary involvement
Posted Sep 11 2009 4:56pm
By Keiko Kinuya and Colleague
Purpose:
Esophageal motility was assessed in patients with systemic sclerosis (SSc) by scintig-raphy and compared with (i) extent of scleroderma, (ii) duration of disease, (iii) index of anti-topoisomerase I antibody (topo I), and (iv) pulmonary involvement.
Methods:
A multiple-swallowtest was performed in 47 patients with SSc in the supine position with 99mTc-DTPA. A region ofinterest on the entire esophagus was defined and the retention ratio (RR) was calculated from a time-activity curve.
Results:
Patients with diffuse scleroderma had higher RRs than those with limitedscleroderma (48.8% vs. 30.0%; p
< 0.05). There was no correlation between the RRs and theduration of disease. Patients with positive topo I had higher RRs than those who were negative(53.8% vs. 29.7%; p
< 0.05). Patients with reduced % diffusion capacity for carbon monoxide(%DLco) had higher RRs than those with normal %DLCo (40.5% vs. 19.6%; p = 0.03). Patients withreduced % vital capacity (%VC) had higher RRs than those with normal %VC (54.6% vs. 25.0%;p
< 0.005). Patients with pulmonary fibrosis had higher RRs than those who were negative (58.5%vs. 20.3%; p
< 0.00005).
Conclusion:
Esophageal dysfunction in patients with SSc showed acorrelation with the extent of scleroderma, positive topo I, and pulmonary involvement. The RR canbe an objective clinical marker for the severity of organ fibrosis.
By Keiko Kinuya and Colleague
Purpose:
Esophageal motility was assessed in patients with systemic sclerosis (SSc) by scintig-raphy and compared with (i) extent of scleroderma, (ii) duration of disease, (iii) index of anti-topoisomerase I antibody (topo I), and (iv) pulmonary involvement.
Methods:
A multiple-swallowtest was performed in 47 patients with SSc in the supine position with 99mTc-DTPA. A region ofinterest on the entire esophagus was defined and the retention ratio (RR) was calculated from a time-activity curve.
Results:
Patients with diffuse scleroderma had higher RRs than those with limitedscleroderma (48.8% vs. 30.0%; p < 0.05). There was no correlation between the RRs and theduration of disease. Patients with positive topo I had higher RRs than those who were negative(53.8% vs. 29.7%; p < 0.05). Patients with reduced % diffusion capacity for carbon monoxide(%DLco) had higher RRs than those with normal %DLCo (40.5% vs. 19.6%; p = 0.03). Patients withreduced % vital capacity (%VC) had higher RRs than those with normal %VC (54.6% vs. 25.0%;p < 0.005). Patients with pulmonary fibrosis had higher RRs than those who were negative (58.5%vs. 20.3%; p < 0.00005).
Conclusion:
Esophageal dysfunction in patients with SSc showed acorrelation with the extent of scleroderma, positive topo I, and pulmonary involvement. The RR canbe an objective clinical marker for the severity of organ fibrosis.