Session Title: Sjögren's Syndrome - Clinical
Session Type: Abstract Submissions (ACR)
Background/Purpose: To study signs of obstructive airway disease in patients with primary Sjögren’s syndrome (pSS) by the forced oscillation technique (FOT), a method that may aid in distinguishing between peripheral and central airway obstruction.
37 female pSS patients (median age 64, range 38-77 years) without known chronic obstructive pulmonary disease (COPD), participating in a longitudinal follow-up study of pulmonary function, and 74 female population-based controls (median age 64, range 47-77 years), also without known COPD, and matched with regard to gender, age, height, weight and tobacco consumption were included in the study. The pSS patients and controls were after inhalation of beta agonist studied by the FOT, evaluating airway resistance and reactance, at different oscillation frequencies, as well as the resonance frequency. pSS patients were also assessed by spirometry according to which 14 were diagnosed with obstructive airway disease (OAD) (12 with COPD and 2 with abnormal reversibility test).
pSS patients had significantly increased resistances at 5-25Hz (p<0.001), decreased reactances at 10-35Hz (p<0.001) and an increased resonance frequency (p=0.002) whilst the resistance slope between 5 and 20Hz was not significantly different (p=NS) in comparison with controls. Airway resistance was negatively correlated and airway reactance positively correlated to the vital capacity, the forced expiratory volume in 1 second and the diffusion capacity for carbon monoxide. Both pSS patients with and without OAD had significantly increased resistances at 5-25Hz (p<0.001) and decreased reactances at 10-35Hz (p<0.001) in comparison with controls respectively, whilst only the former had a significantly increased resonance frequency (p<0.001).
pSS patients showed FOT signs of airway obstruction, possibly due to airway sicca, impaired mucus clearance and bronchial inflammation. OAD also affect central airways in pSS. Also pSS patients without spirometric signs of OAD show clear FOT signs of airway obstruction. FOT thus seems to be a sensitive method in detecting airway obstruction in pSS patients.
A. M. Nilsson,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-forced-oscillation-technique-is-a-sensitive-method-for-detection-of-obstructive-airway-disease-in-patients-with-primary-sjogrens-syndrome/