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Small Airways Dysfunction in Systemic Sclerosis (9)

Small Airways Dysfunction in Systemic Sclerosis (9)Finally, in the 31 patients, with scleroderma we found seven (six female, one male) patients (22.6 percent) with a MEF25 value lower than 60 percent predicted. All these patients were considered to have SAD irregardless of the pattern of abnormality in their other pulmonary function tests. Two of them had MEF25 reduction as a sole abnormality. Four patients had also reduced lung volumes and/or diffusing impairment, while one patient had reduced lung volumes, diffusing impairment, and large airways obstruction. The mean age and disease duration of these patients were 56.6±6.2 years and 6.0±4.7 years, respectively. Four patients had the diffuse disease and the remaining three had limited form of the disease.

Positive serologic features were found in five of the above seven patients. Four of them had pulmonary symptoms and clinical findings, while six had roentgenologic abnormalities. These 7 of 19 patients with SAD had no differences from the rest of the 12 of 19 patients with abnormal lung function test results but with no evidence of SAD, in the mean age, disease duration and form, serologic features, pulmonary symptoms, clinical findings, and roentgenologic abnormalities (Table 4). Significant differences were found between the above two subgroups of patients in the MEF25 and Deo mean values (Table 5).

Table 4—Demographic Data and Clinical and Laboratory Finding? in Patients with Abnormal Lung Function with and without Small Airways Dysfunction (SAD)

Patients
SAD-Positive (n = 7) SAD-Negative (n = 12)
Sex
Female 6 11
Male 1 1
Age, yr 56.6 ±6.2 53.2 ±20.3
Disease duration, yr 6.0±4.7 9.0 ±6.0
Disease form
Diffuse (pts) 4 (57) 10 (83)
Limited (pts) 3 (43) 2(17)
Pulmonary symptoms (pts) 3 (43) 10 (83)
Clinical findings (pts) 3(43) 5(41)
Positive serologic features (pts) 5(71) 10 (83)
Roentgenologic findings (pts) 6 (86) 12 (100)

Table 5—Pulmonary Function Tests in Patients with Abnormal Lung Function with and without Small Airways Dysfunction (SAD) (Mean ± SD)

SAD Positive (n = 7) SAD Negative (n = 12)
FVC, % predicted 81.2 ±10 65.3 ± 18
FEV,, % predicted 79.8 ±24.8 68.2 ±16.3
FEVj/FVC, X100 82 ±9.7 89.7 ±5.8
MEF25, % predicted 46 ±10.3* 101 ±21.6
TLC, % predicted 86± 19 70 ± 17
RY % predicted 102.2 ±28.2 80.2 ±26.7
RV/TLC, X100 38± 19 41.5±6.6
Deo, % predicted 81.2±21.1t 52.5 ±7.4
Kco, % predicted 83.3 ± 19.1 63.1 ±9.7
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