Scleroderma

Patients at high risk of deterioration or death from Systemic Sclerosis-related interstitial lung disease can be readily spotted using CT scans, suggest Melbourne researchers.

Patients classified as having “extensive” (> 20%) lung disease as seen on an HRCT-lung  scan were three times more likely to die, need supplementary oxygen or a lung transplant, the authors wrote in Rheumatology.

Baseline HRCT-lung scans were available for 172 patients, who were followed for a mean of 3.5 years, with 30 experiencing an adverse outcome.

The level of lung disease identified on the scans was graded as ‘extensive’ (>20%), ‘limited’ (<20%) or ‘indeterminate’. Those classified as ‘indeterminate’ were allocated to either extensive or limited by looking at forced vital capacity, the authors said.

“I think it’s very important to have a HRCT-lung [scan] to confirm the diagnosis of interstitial lung disease in patients with Scleroderma,” author Dr Mandana Nikpour of the University of Melbourne and St Vincent’s Hospital Melbourne told Rheumatology Update.

“What we have confirmed is that there is an added value in that enables one to prognosticate as well.”

However Dr Nikpour did not recommend serial HRCT-lung scans because of the radiation exposure and cost and said that performing serial pulmonary function tests was a better way to track changes over time.

Saying that their grading system was “simple and quick” the authors proposed “the routine use of this HRCT grading system to obtain prognostic information in patients with SSc-ILD.”

Source: Pain, C (2012), "Simple predictor in systemic sclerosis-related ILD"; Rheumatology Update; Original article can be viewed here.