ab1902

Bronchiectasis in systemic sclerosis. A study using high resolution computed tomography

A.P. Andonopoulos, S. Yarmenitis¹, P. Georgiou, A. Bounas, C. Vlahanastasi

Department of Medicine, Division of Rheumatology, and Department of Radiology¹, University of Patras School of Medicine, Patras, Greece.

ABSTRACT
Objective
To detect noninvasively the presence of bronchiectasis in patients with systemic sclerosis (SSc), through the use of high resolution chest computed tomography (HRCT).

Methods
Twenty two patients with SSc, of whom 13 with diffuse and 9 with limited disease, besides a complete history, physical and routine laboratory and immunologic profile, were evaluated by pulmonary function testing and HRCT. The chi square test with YatesÕ correction, the Fisher's exact test, the Fisher's test (F test) and the "t" test were used for statistical analysis of the results.

Results
Eleven patients (50.0%) had decreased carbon monoxide diffusing lung capacity (DLCO) and, out of these, four had restrictive lung disease, based on a combined decrease of forced vital capacity (FVC) and total lung capacity (TLC). Another two patients exhibited this pattern without DLCO impairment. HRCT revealed a ground glass picture in 15 patients (68.2%), fibrosis in 9 (40.9%) (of which 5 with ground glass as well), and cylindrical bronchiectasis in 13 (59.1%). Bronchiectasis was more common in diffuse than in limited SSc, and the difference approached but did not reach the level of statistical significance. On the other hand, it was not correlated with either decreased DLCO, presence of ground glass and fibrosis, or with patients' age and disease duration.

Conclusion
Although the number of patients included in our study is relatively small, our data, for the first time in the literature, indicate a significant association between scleroderma and bronchiectasis. Bronchiectasis should be included in the list of pulmonary manifestations of SSc, and SSc in the list of conditions causing bronchiectasis.

Key words
Systemic sclerosis, bronchiectasis, high resolution computed tomography.

Please address correspondence and reprint requests to: Andrew P. Andonopoulos, MD, FACP, Professor of Internal Medicine and Rheumatology, University of Patras School of Medicine, 265 00 Rio, Patras, Greece.