Onset and progression factors for Systemic Sclerosis-associated interstitial lung disease: Data from a North African cohort
DOI:
https://doi.org/10.62438/tunismed.v104i08.6411Keywords:
Systemic sclerosis, Interstitial lung disease, onset, progression, chest tomographyAbstract
Introduction: Screening for interstitial lung disease (ILD) at the onset of systemic sclerosis (SSc) as well as during follow-up is mandatory. The aim of our study was to define the risk factors of SSc-ILD onset and progression in a Tunisian population.
Methods: This was a bicentric, descriptive, retrospective study that included patients with SSc. Data from the initial evaluation and from a 3-year follow-up (FUT) were collected. The patients' chest tomography (CT) scans were reinterpreted by a radiologist specialized in thoracic imaging using the Goh score.
Results: Forty-nine patients were included. ILD was diagnosed at FUT in 31 patients (63%), of whom 35% had progressive disease. The most common radiological pattern was nonspecific interstitial pneumonia (68%). The mean values for the global extension and overall severity score
of ILD at FUT were 33.3% and 5.61, respectively. Factors associated with ILD onset included: A higher modified Rodnan skin score (p=0.008; OR=1.16, 95% CI [1.04–1.3]), pulmonary hypertension (p=0.004; OR=9.35, 95% CI [1.093–30.011]), esophageal involvement (p=0.044; OR=3.650,
95% CI [0.494–26.945]), anti-topoisomerase I antibodies (p=0.001; OR=9.344, 95% CI [2.352–37.123]) and a lower hemoglobin level (p=0.04; OR=8.576, 95% CI [1.481–15.912]). ILD progression factors included: a lower forced vital capacity (p=0.002; OR=0.797, 95% CI [0.637–0.998]), anti-
topoisomerase I antibodies (p=0.015), elevated C-reactive protein (p=0.038; OR=5.07, 95% CI [1.09–30.3]), an indeterminate radiological pattern (p=0.048).
Conclusion: A higher mRSS, esophageal involvement, pulmonary hypertension, anti-topoisomerase I antibodies and anemia were factors associated with ILD onset. Progression risk factors were reduced baseline respiratory volumes and biological inflammatory syndrome.
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