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Lung involvement in patients with primary Sjögrens syndrome: What are the predictors?
Rheumatology International, 10/26/09

Yazisiz V et al. – The presence of hypergammaglobulinemia and lymphopenia, positivity for RF, anti-La and anti-Ro, and impaired (FVC) and/or FEV1 values could be the predictive parameters with a high specificity despite the low sensitivity rates. Smoking history, male gender and age are also risk factors. These parameters may be helpful to distinguish pSS-associated lung involvement from lung disorders unrelated to pSS.

• Retrospective cohort study
• 123 patients with demographic, clinical, laboratory and radiological data diagnosed with pSS
• Lung involvement defined based on presence of pulmonary signs/symptoms and/or impaired pulmonary function tests along with alterations in high-resolution computerized tomography (HRCT)

• 30 patients (24.4%) had pulmonary signs/symptoms at initial presentation and/or during follow-up period
• Based on criteria, 14 patients (11.4%) defined as having pSS with lung involvement
• Positive IgM-rheumatoid factor (RF), anti-La and anti-Ro results, the presence of hypergammaglobulinemia and lymphopenia had high specificity despite low sensitivity rates to detect pSS-associated lung disease
• Significant difference was found in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) results between the patients with and without lung involvement
• Impaired FEV1 had high specificity and positive predictive value compared to impaired FVC, particularly in non-smoker patients
• Most frequent HRCT finding was ground-glass attenuation (64.3%)
• Significant difference found in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) results between patients with and without lung involvement.
Other common findings were bronchiectasis, reticular pattern and honeycombing

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