Study of pulmonary mainfestations in systemic sclerosis

ABSTRACT

Pulmonary involvement is frequent in systemic sclerosis, which leads to reduction in lung volumes and gas transfer across the alveolocapillary barrier and alteration of the pulmonary functions. The aim of this work was to study the pulmonary [functional and structural] changes in patients with systemic sclerosis. Thirty subjects comprised the material of this study, twenty of them had systemic sclerosis and ten were normal healthy volunteers as a control group. They were subjected to thorough history taking, complete clinical examination, PFT, BAL, CXR, 2D Echocardiography and HRCT. It was found that the mean values of FVC and DLCO were significantly lower in sysiemic sclerosis patients than those in normal control group. Also the lymphocytes, granulocytes, IgG and albumin in BAL fluid of patients with systemic scterosis were significantly higher than that in the normal control. HRCT scores were significantly higher in systemic sclerosis patients than normal control and also were higher in patients with abnormal BAL than those with normal BAL. It was concluded that 1. Patients with systemic sclerosis have an inflammatory aiveolitis with hypercellularity and increased percentage of granulocytes recovered from the lower respiratory tract by BAL. 2. The significant correlalion between the degree of alveolitis and the degree of decline in PFT in such patients, increases the value oi BAL in identification of high risk group. 3. HRCT is an excellent radiodiagnostic tool for quantification of lurig lesions in systemic sclerosis and also for predication of sequale of these lesions on pulmonary functions