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Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2020.0043    [Accepted]
Published online July 15, 2020.
Short-term lung function changes and predictors of progressive systemic sclerosis-related interstitial lung disease
Punchalee Kaenmuang, M.D., Asma Navasakulpong, M.D.
Instructor of Respiratory and respiratory critical care medicine unit, Division of Internal Medicine, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Received: 27 April 2020   • Revised: 17 June 2020   • Accepted: 15 July 2020
Abstract
Background
Systemic sclerosis (SSc) involves multiple organ systems and has the highest mortality in connective tissue disease. Interstitial lung disease is the most common cause of death among SSc patients and requires closer studies and follow-ups. This study aimed to identify lung function changes and predictors of progressive disease in systemic sclerosis-related interstitial lung disease (SSc-ILD).
Methods
A retrospective study extracted SSc patients from an electronic database from January 2002 to July 2019. Eligible cases were SSc patients >15 years old diagnosed with SSc-ILD. Factors associated with progressive disease were analyzed by univariate and multivariate logistic regression analyses.
Results
Seventy-eight SSc-ILD cases were enrolled. Sixty-five (83.3%) patients were female, the mean age was 44.7±14.4 years, and 50 (64.1%) were diffuse type SSc-ILD. Most SSc-ILD patients had crackles (75.6%) and dyspnea on exertion (71.8%), and 19.2% of the SSc-ILD patients had no abnormal respiratory symptoms but had abnormal chest radiographic findings. The most common diagnosis of SSc-ILD patients was nonspecific interstitial pneumonia (43.6%). The lung function values of DLCO and DLCO/VA declined in progressive SSc-ILD during a 12-month follow-up period. Male and no previous aspirin treatment were the two significant predictive factors of progressive SSc-ILD with adjusted odds ratios of 5.72 and 4.99, respectively.
Conclusion
The present study shows short-term lung function had declined during the 12-month follow-up in progressive SSc-ILD. The predictive factors in progressive SSc-ILD were male gender and no previous aspirin treatment. Close follow-up of pulmonary function tests is necessary for early detection of progressive disease.
Key Words: Lung function parameters, Predictive factors, Systemic sclerosis-related, interstitial lung disease


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