Tomoyuki Kakugawa1, Noriho Sakamoto2, Hiroshi Ishimoto2, Toshimasa Shimizu3, Hideki Nakamura3, Aya Nawata4, Chiyo Ito5, Shuntaro Sato6, Tetsuya Hanaka5, Keishi Oda5, Takashi Kido5, Takuto Miyamura2, Shota Nakashima2, Takatoshi Aoki7, Seiko Nakamichi8, Yasushi Obase2, Kazuyoshi Saito9, Kazuhiro Yatera5, Yuji Ishimatsu10, Toshiyuki Nakayama11, Yukunori Korogi7, Atsushi Kawakami3, Yoshiya Tanaka12, Hiroshi Mukae2. 1. Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: kakugawa@nagasaki-u.ac.jp. 2. Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 3. Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 4. Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. 5. Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. 6. Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan; Division of Biostatistics, Kurume University School of Medicine, Kurume, Japan. 7. Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. 8. Department of General Medicine, Nagasaki University School of Medicine, Nagasaki, Japan. 9. Department of Rheumatology, Tobata General Hospital, Kitakyushu, Japan. 10. Department of Cardiopulmonary Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 11. Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan. 12. The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Abstract
OBJECTIVE: Although high-resolution computed tomography (HRCT) is useful for the characterization of minute morphological changes in the lungs, no study has investigated risk factors for lung involvement detected by HRCT in patients with Sjögren's syndrome with or without respiratory symptoms. The aim of the current study was to investigate risk factors for lung involvement in patients with primary Sjögren's syndrome detected by HRCT, with a particular focus on airway and interstitial lung diseases. METHODS: We performed a retrospective cohort study of patients with primary Sjögren's syndrome and investigated risk factors for lung involvement detected by HRCT. A total of 101 patients with primary Sjögren's syndrome with initial HRCT examinations were enrolled. RESULTS: Higher age, dry mouth, and higher labial gland biopsy focus scores (≥4) were risk factors for airway diseases (odds ratio [OR] 1.064 confidence interval [CI] 1.026-1.102, OR 8.795 CI 2.317-33.378 and OR 3.261 CI 1.100-9.675, respectively) in the multivariable analysis. Higher age, male sex, and higher labial gland biopsy focus scores (≥4) were risk factors for interstitial lung diseases (OR 1.078 CI 1.032-1.127, OR 12.178 CI 1.121-132.307 and OR 3.954 CI 1.423-10.987, respectively) in the multivariable analysis. The presence of anti-T-lymphotropic virus type 1 antibodies was significantly more common in patients with airway diseases. CONCLUSIONS: This study showed significant associations of labial gland biopsy focus scores and dry mouth with pulmonary manifestations in patients with primary Sjögren's syndrome. Focus scores as well as dry mouth may reflect lymphoproliferative activity in the lungs in patients with primary Sjögren's syndrome.
OBJECTIVE: Although high-resolution computed tomography (HRCT) is useful for the characterization of minute morphological changes in the lungs, no study has investigated risk factors for lung involvement detected by HRCT in patients with Sjögren's syndrome with or without respiratory symptoms. The aim of the current study was to investigate risk factors for lung involvement in patients with primary Sjögren's syndrome detected by HRCT, with a particular focus on airway and interstitial lung diseases. METHODS: We performed a retrospective cohort study of patients with primary Sjögren's syndrome and investigated risk factors for lung involvement detected by HRCT. A total of 101 patients with primary Sjögren's syndrome with initial HRCT examinations were enrolled. RESULTS: Higher age, dry mouth, and higher labial gland biopsy focus scores (≥4) were risk factors for airway diseases (odds ratio [OR] 1.064 confidence interval [CI] 1.026-1.102, OR 8.795 CI 2.317-33.378 and OR 3.261 CI 1.100-9.675, respectively) in the multivariable analysis. Higher age, male sex, and higher labial gland biopsy focus scores (≥4) were risk factors for interstitial lung diseases (OR 1.078 CI 1.032-1.127, OR 12.178 CI 1.121-132.307 and OR 3.954 CI 1.423-10.987, respectively) in the multivariable analysis. The presence of anti-T-lymphotropic virus type 1 antibodies was significantly more common in patients with airway diseases. CONCLUSIONS: This study showed significant associations of labial gland biopsy focus scores and dry mouth with pulmonary manifestations in patients with primary Sjögren's syndrome. Focus scores as well as dry mouth may reflect lymphoproliferative activity in the lungs in patients with primary Sjögren's syndrome.
Authors: Rohan Sharma; Kaustubh S Chaudhari; Biji T Kurien; Kiely Grundahl; Lida Radfar; David M Lewis; Christopher J Lessard; He Li; Astrid Rasmussen; Kathy L Sivils; R Hal Scofield Journal: J Rheumatol Date: 2019-05-15 Impact factor: 4.666