Session Information
Date: Tuesday, November 10, 2015
Title: Sjögren's Syndrome: Translational Insights into Sjögren's Syndrome
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Lung involvement is a systemic manifestation of primary Sjögren’s syndrome (pSS), however, the prevalence in pSS is various (9-75 %) and details are still unclear. In addition, interstitial lung disease (ILD) associated with pSS shows several radiographic patterns such as nonspecific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). Although UIP pattern is known as a prognostic determinant in idiopathic interstitial pneumonia, risk factors for progression of ILD in pSS has not been established.The aim of this study is to investigate clinical features of lung involvement in pSS and prognostic factors for exacerbation of pSS-ILD.
Methods: Total 300 consecutive patients with pSS diagnosed according to the 1999 revised Japanese criteria for the diagnosis of pSS, between January 2012 and September 2014 at our division were enrolled after exclusion of secondary SS. Clinico-radiolographic characteristics were retrospectively investigated and statistically analyzed. ILD progression was defined by exacerbation on chest computed tomography (CT) image or pulmonary function test.
Results: To screen lung involvements, chest X-ray was underwent in 239 patients and chest CT was evaluated in 111 patients. Lung involvements were confirmed in 31.4%. Mean age was 68.5 years old. This included ILD (n=23, 9.6%), chronic airway lesion (n=11, 4.6 %), cystic lesion (n=3, 1.3 %), and malignant lymphoma (n=3, 1.3 %). Notably, the prevalence of smoking history (≥10 cigarettes per day, p=0.03), and elderly (≥65 years old, p<0.01) were higher in pSS with lung involvement than pSS without lung involvement. Radiological patterns of 23 pSS-ILD were followings: 17 for NSIP (73.9%), 5 for UIP (21.7%) and 1 OP (4.35%). 9 were progressive and 17 were stable during observation periods. Comparing ILD progressive group with stable group, serum immunoglobulin (Ig) G were significantly elevated (2263 +/- 479 vs 1726 +/- 519 mg/dl, p=0.02) and ESSDAI was higher (10.8 +/- 1.9 vs 6.1 +/- 1.3, p<0.01).There was no significant difference in the extent of reticular abnormality, ground glass attenuation, consolidation, and micronodules between two groups. On the other hand, UIP patterns having honeycombing were significantly higher in ILD-progressive group (p=0.04). Remarkably, serum IgG levels were significantly elevated in the progressive case with UIP pattern (p=0.02), but not with NSIP pattern.
Conclusion: This study demonstrated that serum IgG levels was elevated in progressive group in pSS-ILD and a prognostic factor particularly in pSS-ILD patients with UIP pattern. In the pSS patients with UIP pattern and serum IgG elevation, careful observation should be needed for appropriate management of ILD.
To cite this abstract in AMA style:
Ishioka E, Suzuki K, Nishina N, Yasuoka H, Yamaoka K, Takeuchi T. Elevated Serum Immunoglobulin G Is a Prognostic Factor for Progression of Interstitial Lung Disease in Primary Sjögren’s Syndrome [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/elevated-serum-immunoglobulin-g-is-a-prognostic-factor-for-progression-of-interstitial-lung-disease-in-primary-sjogrens-syndrome/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/elevated-serum-immunoglobulin-g-is-a-prognostic-factor-for-progression-of-interstitial-lung-disease-in-primary-sjogrens-syndrome/