Pulmonary involvement in long-term mixed connective tissue disease: Functional trends and imaging findings after 10 years

Leticia Kawano-Dourado, Bruno G. Baldi, Fernando U. Kay, Olivia M. Dias, Thais E.H. Gripp, Paula S. Gomes, Ricardo Fuller, Maria T.C. Caleiro, Ronaldo A. Kairalla, Carlos R.R. Carvalho

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: Interstitial lung disease (ILD) is highly prevalent in patients with mixed connective tissue disease (MCTD). However, little is known about the long-term progression of ILD in MCTD. The aims of this study were to describe pulmonary function test (PFT) and high-resolution computed tomography (HRCT) results in long-term MCTD patients, to measure changes in PFT and HRCT results over a 10-year period, and to ascertain correlations in functional and imaging data. Methods: In this retrospective cohort study, comparison between baseline and follow-up PFT and HRCT data was performed for 39 unselected consecutive MCTD patients. Results: At baseline, 51% of the patients had abnormal PFTs. Forced vital capacity (FVC) was slightly reduced at baseline (77% of predicted), but remained stable after 10 years. A relative decrease of 15% in the diffusion capacity for carbon monoxide (DLCO) was detected (from 84% to 71% of predicted, p<0.001). The median lower lobes ILD-HRCT score progressed from 7.5% at baseline to 11.2% at follow-up (p=0.02), and findings of traction bronchiolectasis and honeycombing increased (p<0.05). A moderate negative correlation was observed between functional parameters and quantification of image findings. Conclusion: Functional and radiologic alterations suggestive of ILD in long-term MCTD patients are prevalent, mild, and progressed slightly over time. The most sensitive parameters for detecting subtle progression of ILD in MCTD patients are trends in DLCO, quantification of lower-lobes disease by HRCT (lower-lobes %ILD-HRCT score), and qualitative analysis of HRCT imaging.

Original languageEnglish (US)
Pages (from-to)234-240
Number of pages7
JournalClinical and Experimental Rheumatology
Volume33
Issue number2
StatePublished - Jan 1 2015

Keywords

  • High-resolution computed tomography
  • Interstitial lung disease
  • Mixed connective tissue disease
  • Pulmonary function test

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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    Kawano-Dourado, L., Baldi, B. G., Kay, F. U., Dias, O. M., Gripp, T. E. H., Gomes, P. S., Fuller, R., Caleiro, M. T. C., Kairalla, R. A., & Carvalho, C. R. R. (2015). Pulmonary involvement in long-term mixed connective tissue disease: Functional trends and imaging findings after 10 years. Clinical and Experimental Rheumatology, 33(2), 234-240.