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Small Airways Dysfunction in Systemic Sclerosis (6)

In 24 (77 percent) of 31 patients, positive serologic features were found: ANA in 21, ACA in six, and Anti-Scl antibodies in seven patients (Table 1).
Patients’ pulmonary (unction studies revealed varied abnormalities for several analyzed indices. The most frequent abnormality was the Deo reduction in 17 patients (55 percent). TLC and FVC were reduced in 11 (35 percent) and in 12 (39 percent) patients, respectively. MEF25 was reduced in seven (22.6 percent) and FEV! in 12 (39 percent) patients, while FEV/FVC was reduced only in one (3 percent) patient. RV and RV/TLC (>0.40) were elevated in 11 (35 percent) patients.
All the 31 control subjects showed normal FVC, TLC, Deo, Kco, and FEVj/FVC values. However, four (13 percent) control subjects had a reduction in MEF25 that was consistent with isolated SAD, while two of them also had elevated RV and RV/TLC levels. The number of patients with reduced MEF25 or elevated RY RV/TLC was not different from that of the control subjects with the corresponding abnormalities. FVC, FEVi, TLC, Deo, and Kco mean values in all patients were significantly lower compared with control subjects. However, no differences were observed between the patients and the controls in FEV1/FVC, MEF25, RV, and RV/TLC mean values, which are related, to large and small airways abnormalities (Table 2).

Table 1—Demographic Data and Clinical and Laboratory Findings in the 31 Fatients with Systemic Sclerosis

Data No.
Sex
Female 28
Male 3
Age, yr 51.5 ±13.4
Disease duration, yr 6.4±4.6
Disease form
Diffuse 20 (65)
Limited 11 (35)
Pulmonary symptoms 13 (42)
Clinical findings 8 (26)
Roentgenologic findings 18 (58)
Positive serologic features 24 (77)

Table 2—Pulmonary Function Tests tn the Fatients with Systemic Sclerosis and the Control Subjects (Mean±SD)

Patients(n-31) Controls(n=31)
FVC, % predicted 82.4 ±20.2 102.1 ±14.2
FEV,, % predicted 83.1 ±19.9 101.4 ±13.0
FEVj/FVC, X100 86.0 ±7.5 91.1 ±14.4
MEF25, % predicted 83.9 ±26.5 91.8 ±31.0
TLC, % predicted 84.8 ±17.4 98.1 ±12.2
KY % predicted 93.7 ±26.3 102.0 ±17
RV/TLC, X100 38.0 ±6.6 36.2 ±5.8
Deo, % predicted 75.3 ±20.9 103.6 ±19.3
Kco, % predicted 73.6 ±16.4 91.1 ±13.2

Category: Pulmonary disease

Tags: pulmonary function, pulmonary involvement, scleroderma, systemic sclerosis

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