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vol. 11
Clinical research

Causes and prevalence of inadequate pulmonary function testing among patients with systemic sclerosis

Pichaporn Sumphao-Ngern, Chingching Foocharoen, Watchara Boonsawat, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Uraiwan Sae-Oue, Sittichai Netwijitpan, Ratanavadee Nanagara, Scleroderma Research Group

Arch Med Sci 2015; 11, 6: 1255–1260
Online publish date: 2015/12/11
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Introduction: Spirometry is a screening tool for evaluating the degree of restrictive lung disease in systemic sclerosis (SSc). Observations indicated that some patients could not complete the test. The aim of the study was to identify the prevalence, causes and clinical predictors of an inadequate pulmonary function test (PFT) in SSc.

Material and methods: A cross-sectional study was performed among SSc patients over 18 years old followed up at Srinagarind Hospital, Khon Kaen, Thailand, during January 2006–December 2012. The adequacy of the PFT was based on the acceptable blow criteria as set out by the American Thoracic Society and the European Respiratory Society 2005 Standardizations of Spirometry.

Results: Two hundred and forty-nine patients were included (female to male ratio was 2 : 1). The mean age at performing PFT was 51.4 ±11.1 years (range: 19.6–79.5). Median duration of disease at performing PFT was 2 years (IQR: 0.6–4.4). Inadequate PFT occurred in 73 cases (prevalence 29.3%: 95% CI: 23.6–35.0); the majority (60 cases; 82.2%) had an expiration time < 6 s and the others were due to plateau < 1 s (11 cases; 15%), air leak around mouth piece (1 case; 1.4%) and hesitation (1 case; 1.4%). Thirteen of 73 (17.8%) had an unusable graph with the overall prevalence of 5.2% (95% CI: 2.4–8.0). The factor associated with inadequate PFT was docy mass index (BMI) < 18.5 kg/m2 (OR = 2.17: 95% CI: 1.49–3.17); the same factor was associated with an unusable graph, which was confirmed by the multivariate analysis (OR = 5.21; 95% CI: 1.60–16.95).

Conclusions: One-third of Thai SSc patients had an inadequate pulmonary function test – the majority because of inadequate time for expiring. Low BMI influenced the effectiveness of the test, leading to an incomplete graph for evaluating lung disease in SSc.

systemic sclerosis, scleroderma, pulmonary function test, forced vital capacity

Silver RM. Clinical aspects of systemic sclerosis (scleroderma). Ann Rheum Dis 1991; 50 Suppl. 4: 854-61.
Steen VD, Medsger TA Jr. Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum 2000; 43: 2437-44.
Steen V. The heart in systemic sclerosis. Curr Rheumatol Rep 2004; 6: 137-40.
Bussone G, Mouthon L. Interstitial lung disease in systemic sclerosis. Autoimmun Rev 2011; 10: 248-55.
Cohen S. The gastrointestinal manifestations of scleroderma: pathogenesis and management. Gastroenterology 1980; 79: 155-66.
Denton CP, Lapadula G, Mouthon L, Müller-Ladner U. Renal complications and scleroderma renal crisis. Rheumatol Oxf Engl 2009; 48 Suppl. 3: iii32-5.
Waszczykowska A, Goś R, Waszczykowska E, Dziankowska-Bartkowiak B, Jurowski P. Prevalence of ocular manifestations in systemic sclerosis patients. Arch Med Sci 2013; 9: 1107-13.
Shah AA, Wigley FM. Often forgotten manifestations of systemic sclerosis. Rheum Dis Clin North Am 2008; 34: 221-38.
Kowalczyk MJ, Dańczak-Pazdrowska A, Szramka-Pawlak B, Zaba R, Silny W, Osmola-Mańkowska A. Expression of selected human endogenous retroviral sequences in skin and peripheral blood mononuclear cells in morphea. Arch Med Sci 2012; 8: 819-25.
Geyer M, Müller-Ladner U. The pathogenesis of systemic sclerosis revisited. Clin Rev Allergy Immunol 2011; 40: 92-103.
Diot E, Boissinot E, Asquier E, et al. Relationship between abnormalities on high-resolution CT and pulmonary function in systemic sclerosis. Chest 1998; 114: 1623-9.
Foocharoen C, Nanagara R, Kiatchoosakun S, Suwannaroj S, Mahakkanukrauh A. Prognostic factors of mortality and 2-year survival analysis of systemic sclerosis with pulmonary arterial hypertension in Thailand. Int J Rheum Dis 2011; 14: 282-9.
Tyndall AJ, Bannert B, Vonk M, et al. Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 2010; 69: 1809-15.
Lopes AJ, Capone D, Mogami R, Menezes SLS de, Guimarães FS, Levy RA. Systemic sclerosis-associated interstitial pneumonia: evaluation of pulmonary function over a five-year period. J Bras Pneumol Publicaçaao Of Soc Bras Pneumol E Tisilogia 2011; 37: 144-51.
Murdaca G, Spanò F, Contatore M, Guastalla A, Puppo F. Potential use of TNF-alpha inhibitors in systemic sclerosis. Immunotherapy 2014; 6: 283-9.
Gatta G, Di Grezia G, Iacomino A, et al. HRCT in systemic sclerosis: correlation between respiratory functional indexes and extension of lung failure. J Biol Regul Homeost Agents 2013; 27: 579-87.
Fries JF, Hochberg MC, Medsger TA Jr, Hunder GG, Bombardier C. Criteria for rheumatic disease. Different types and different functions. The American College of Rheumatology Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum 1994; 37: 454-62.
LeRoy EC, Black C, Fleischmajer R, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 1988; 15: 202-5.
Randone SB, Guiducci S, Cerinic MM. Musculoskeletal involvement in systemic sclerosis. Best Pract Res Clin Rheumatol 2008; 22: 339-50.
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319-38.
Caramaschi P, Biasi D, Caimmi C, et al. Relationship between body composition and both cardiovascular risk factors and lung function in systemic sclerosis. Clin Rheumatol 2014; 33: 77-82.
Rossi A, Fantin F, Di Francesco V, et al. Body composition and pulmonary function in the elderly: a 7-year longitudinal study. Int J Obes 2005 2008; 32: 1423-30.
Pope JE. Musculoskeletal involvement in scleroderma. Rheum Dis Clin North Am 2003; 29: 391-408.
Braun NM, Arora NS, Rochester DF. Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies. Thorax 1983; 38: 616-23.
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