Evaluation of pulmonary involvement in
systemic rheumatic diseases with high resolution
computed tomography and pulmonary function
test: A single-center experience

Pazarlı, Ahmet Cemal; Yuksekkaya, Ruken; Ekiz, Timur; Inonu Koseoglu, Handan; Yakar, Halil Ibrahim

doi:10.5578/tt.20219801

Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience

Ahmet Cemal PAZARLI, (Department of Chest Diseases, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey)

Halil İbrahim YAKAR, (Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Tokat, Türkiye)

Handan İNÖNÜ KÖSEOĞLU, (Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Tokat, Türkiye)

Ruken YÜKSEKKAYA ÇELİKYAY, (Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Tokat, Türkiye)

Timur EKİZ (Dermancan Tıp Merkezi, Fizik Tedavi ve Rehabilitasyon Birimi, Adana, Türkiye)

Tüberküloz ve Toraks

0 0

Yıl: 2021 Cilt: 69 Sayı: 2 Sayfa Aralığı: 125 - 132 Metin Dili: İngilizce DOI: 10.5578/tt.20219801 İndeks Tarihi: 01-06-2022

Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience

Öz:

Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience Introduction: The objective of this study was to investigate the clinical and radiological features and pulmonary function tests (PFTs) in patients with the pulmonary involvement of systemic rheumatic diseases (SRDs). Materials and Methods: This study was conducted as a retrospective and single-center study. Patients diagnosed with an SRD and admitted/referred to the department of chest diseases of our hospital between January 2015 and June 2019 were enrolled. All patients were evaluated using High Resolution Computed Tomography (HRCT) and PFT. Results: This study included 68 patients (15 males, 53 females) with a mean age of 62.38 ± 12.4 years. Forty-one (60.2%) patients had diagnosis of rheumatoid arthritis (RA), 10 (14.7%) patients had sjögren’s syndrome (SS), 8 (11.7%) patients had systemic lupus erythematosus (SLE), 6 (8.8%) patients had systemic sclerosis (SSc), and 3 (4.4%) patients had mixed connective tissue disease (MCTD). While RA, SLE, MCTD patients were more commonly symptomatic, most of the SS patients were asymptomatic. Overall, 30 (44.1%) patients had normal PFT. Although 30 (%44.1) patients were asymptomatic and 30 (%44.1) patients had normal PFTs, at least one imaging finding was found in all patients according to HRCT imaging. “Bronchiectasis” was the most common HRCT finding in RA, followed by “chronic fibrotic changes” and “peribronchial thickening”. “Chronic fibrotic changes” and “peribronchial thickening” were the most common changes in SS. Similarly, “peribronchial thickening” was the most common radiologic finding in SLE. As for SSc, “chronic fibrotic changes”, “interlobular septal thickening”, and “pleural effusion” were the most common radiologic findings. Conclusion: Pulmonary involvement in systemic rheumatic diseases can occur with various radiological images even in asymptomatic patients. PFTs can be normal as well as an obstructive, restrictive or mixed pattern can be seen. Heterogeneous and combined HRCT findings can be seen in SRD patients

Anahtar Kelime:

Sistemik romatizmal hastalıklarda akciğer tutulumunun, yüksek çözünürlüklü bilgisayarlı tomografi ve solunum fonksiyon testi ile değerlendirilmesi: Tek merkez deneyimi

Öz:

Giriş: Bu çalışmanın amacı, sistemik romatizmal hastalıklarda (SRH) akciğer tutulumu olan hastalarda klinik, radyolojik özellikler ve solunum fonksiyon testlerini (SFT) araştırmaktır. Materyal ve Metod: Bu çalışma retrospektif, tanımlayıcı ve tek merkezli olarak gerçekleştirildi. Ocak 2015 - Aralık 2019 yılları arasında SRH tanısı alan ve üçüncü basamak sağlık kurumu olan hastanemiz göğüs hastalıkları bölümüne başvuran/sevk edilen hastalar çalışmaya alındı. Tüm hastalar Yüksek rezolüsyonlu akciğer tomografisi (HRCT) ve SFT kullanılarak değerlendirildi. Bulgular: Çalışmaya ortalama yaşı 62,38 ± 12,4 yıl olan 68 hasta (15 erkek, 53 kadın) dahil edildi. Hastaların 41’inde (%60,2) romatoid artrit (RA), 10’unda (%14,7) sjögren sendromu (SS), 8’inde (%11,7) sistemik lupus eritematozus (SLE), 6’sında (%8,8) sistemik skleroz (SSc) ve 3’ünde (%4,4) mix bağ dokusu hastalığı (MBDH) mevcuttu. RA, SLE, MBDH hastaları genellikle semptomatik iken, SS hastaları genellikle asemptomatikti. Toplam 30 (%44,1) hastada SFT normal olarak değerlendirildi. 30 (%44,1) hasta asemptomatik olduğu halde ve diğer 30 (%44,1) hastada normal SFT bulguları saptanmasına rağmen, HRCT ile tüm hastalarda birden fazla görüntüleme bulgusu saptandı. RA’da en sık görülen HRCT bulgusu “bronşektazi” idi, bunu “kronik fibrotik değişiklikler” ve “peribronşiyal kalınlaşma” izledi. “Kronik fibrotik değişiklikler” ve “peribronşiyal kalınlaşma”, SS’deki en yaygın değişikliklerdi. Benzer şekilde, “peribronşiyal kalınlaşma” SLE’ de en sık görülen HRCT bulgusuydu. SSc’de ise, “kronik fibrotik değişiklikler”, interlobüler septal kalınlaşma ve plevral efüzyon en sık görülen HRCT bulgularıydı. Sonuç: Sistemik romatizmal hastalıklarda pulmoner tutulum, asemptomatik hastalarda dahi çeşitli radyolojik görüntülerle ortaya çıkabilir. SFT normal olabileceği gibi obstruktif, restriktif veya mikst paternde olabilir. Birçok (heterojen) HRCT bulgusu görülebilir

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Dumas G, Géri G, Montlahuc C, Chemam S, Dangers L, Pichereau C, et al. Outcomes in critically ill patients with systemic rheumatic disease. Chest 2015; 148(4): 927-35.
2. Dellaripa PF, Fischer A, Flaherty KR. Pulmonary Manifestations of Rheumatic Disease: A Comprehensive Guide. New York: Springer; 2014.
3. Ha YJ, Lee YJ, Kang EH. Lung involvements in rheumatic diseases: update on the epidemiology, pathogenesis, clinical features, and treatment. Biomed Res Int 2018; 6930297.
4. Doyle TJ, Dellaripa PF. Lung manifestations in the rheumatic diseases. Chest 2017; 152(6): 1283-95.
5. Karazincir S, Akoğlu S, Güler H, Balci A, Babayiğit C, Eğilmez E. The evaluation of early pulmonary involvement with high resolution computerized tomography in asymptomatic and non-smoker patients with rheumatoid arthritis. Tuberk Toraks 2009; 57(1): 14-21.
6. Perelas A, Arrossi AV, Highland KB. Pulmonary manifestations of systemic sclerosis and mixed connective tissue disease. Clin Chest Med 2019; 40(3): 501-18.
7. Natalini JG, Johr C, Kreider M. Pulmonary involvement in Sjögren syndrome. Clin Chest Med 2019; 40(3): 531-44.
8. Gutierrez M, Salaffi F, Carotti M, Tardella M, Pineda C, Bertolazzi C, et al. Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders: preliminary results. Arthritis Res Ther 2011; 13(4): R134
9. García-Río F, Calle M, Burgos F, Casan P, Del Campo F, Galdiz JB, et al. Spirometry. Arch Bronconeumol 2013; 49(9): 388-401.
10. Ulubay G, Dilektaşlı AG, Börekçi Ş, Yıldız Ö, Kıyan E, Gemicioglu B, et al.Turkish Thoracic Society Consensus Report: Interpretation of Spirometry. Turk Thorac J 2019; 20(1): 69-89.
11. Vitali C, Viegi G, Tassoni S, Tavoni A, Paoletti P, Bibolotti E, et al. Lung function abnormalities in different connective tissue diseases. Clin Rheumatol 1986; 5(2): 181-8.
12. Renzoni E, Rottoli P, Coviello G, Perari MG, Galeazzi M, Vagliasindi M. Clinical, laboratory and radiological findings in pulmonary fibrosis with and without connective tissue disease. Clin Rheumatol 1997; 16(6): 570-7.
13. Fujii M, Adachi S, Shimizu T, Hirota S, Sako M, Kono M. Interstitial lung disease in rheumatoid arthritis: assessment with high-resolution computed tomography. J Thorac Imaging 1993; 8(1): 54-62.
14. Ayhan-Ardic FF, Oken O, Yorgancioglu ZR, Ustun N, Gokharman FD. Pulmonary involvement in lifelong nonsmoking patients with rheumatoid arthritis and ankylosing spondylitis without respiratory symptoms. Clin Rheumatol 2006; 25(2): 213-8.
15. Lieberman-Maran L, Orzano IM, Passero MA, Lally EV. Bronchiectasis in rheumatoid arthritis: report of four cases and a review of the literature implications for management with biologic response modifiers. Semin Arthritis Rheum 2006; 35(6): 379-87.
16. Akira M, Sakatani M, Hara H. Thin-section CT findings in rheumatoid arthritis-associated lung disease: CT patterns and their courses. J Comput Assist Tomogr 1999; 23(6): 941-8.
17. Zrour SH, Touzi M, Bejia I, Golli M, Rouatbi N, Sakly N, et al. Correlations between high-resolution computed tomography of the chest and clinical function in patients with rheumatoid arthritis: prospective study in 75 patients. Joint Bone Spine 2005; 72(1): 41-7.
18. Devaraj A, Wells AU, Hansell DM. Computed tomographic imaging in connective tissue diseases. Semin Respir Crit Care Med 2007; 28(4): 389-97.
19. Matsuyama N, Ashizawa K, Okimoto T, Kadota J, Amano H, Hayashi K. Pulmonary lesions associated with Sjögren’s syndrome: radiographic and CT findings. Br J Radiol 2003;76: 880-4.
20. 20. Desai SR, Veeraraghavan S, Hansell DM, Nikolakopolou A, Goh NSL, Nicholson AG, et al. CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology 2004; 232(2): 560-7.
21. Fenlon HM, Doran M, Sant SM, Breatnach E. Highresolution CT in systemic lupus erythematosus. AJR Am J Roentgenol 1996; 166(2): 301-7.
22. Bankier AA, Kiener HP, Wiesmayr MN et al.Discrete lung involvement in systemic lupus erythematosus: CT assessment. Radiology 1995; 196(3): 835-40.
23. Prakash UB. Respiratory complications in mixed connective tissue disease. Clin Chest Med 1998; 19(4): 733-46

APA	Pazarlı A, Yakar H, Inonu Koseoglu H, Yuksekkaya R, Ekiz T (2021). Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. , 125 - 132. 10.5578/tt.20219801
Chicago	Pazarlı Ahmet Cemal,Yakar Halil Ibrahim,Inonu Koseoglu Handan,Yuksekkaya Ruken,Ekiz Timur Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. (2021): 125 - 132. 10.5578/tt.20219801
MLA	Pazarlı Ahmet Cemal,Yakar Halil Ibrahim,Inonu Koseoglu Handan,Yuksekkaya Ruken,Ekiz Timur Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. , 2021, ss.125 - 132. 10.5578/tt.20219801
AMA	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. . 2021; 125 - 132. 10.5578/tt.20219801
Vancouver	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. . 2021; 125 - 132. 10.5578/tt.20219801
IEEE	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T "Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience." , ss.125 - 132, 2021. 10.5578/tt.20219801
ISNAD	Pazarlı, Ahmet Cemal vd. "Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience". (2021), 125-132. https://doi.org/10.5578/tt.20219801

APA	Pazarlı A, Yakar H, Inonu Koseoglu H, Yuksekkaya R, Ekiz T (2021). Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. Tüberküloz ve Toraks, 69(2), 125 - 132. 10.5578/tt.20219801
Chicago	Pazarlı Ahmet Cemal,Yakar Halil Ibrahim,Inonu Koseoglu Handan,Yuksekkaya Ruken,Ekiz Timur Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. Tüberküloz ve Toraks 69, no.2 (2021): 125 - 132. 10.5578/tt.20219801
MLA	Pazarlı Ahmet Cemal,Yakar Halil Ibrahim,Inonu Koseoglu Handan,Yuksekkaya Ruken,Ekiz Timur Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. Tüberküloz ve Toraks, vol.69, no.2, 2021, ss.125 - 132. 10.5578/tt.20219801
AMA	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. Tüberküloz ve Toraks. 2021; 69(2): 125 - 132. 10.5578/tt.20219801
Vancouver	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience. Tüberküloz ve Toraks. 2021; 69(2): 125 - 132. 10.5578/tt.20219801
IEEE	Pazarlı A,Yakar H,Inonu Koseoglu H,Yuksekkaya R,Ekiz T "Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience." Tüberküloz ve Toraks, 69, ss.125 - 132, 2021. 10.5578/tt.20219801
ISNAD	Pazarlı, Ahmet Cemal vd. "Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience". Tüberküloz ve Toraks 69/2 (2021), 125-132. https://doi.org/10.5578/tt.20219801