PT  - JOURNAL ARTICLE
AU  - Anna Matilda Nilsson
AU  - H. Laura Aaltonen
AU  - Peter Olsson
AU  - Hans Lennart Persson
AU  - Roger Hesselstrand
AU  - Elke Theander
AU  - Per Wollmer
AU  - Thomas Mandl
TI  - Mixed Airway and Pulmonary Parenchymal Disease in Patients With Primary Sjögren Syndrome: A 6-year Follow-up
AID  - 10.3899/jrheum.200247
DP  - 2021 Feb 01
TA  - The Journal of Rheumatology
PG  - 232--240
VI  - 48
IP  - 2
4099  - http://www.jrheum.org/content/48/2/232.short
4100  - http://www.jrheum.org/content/48/2/232.full
SO  - J Rheumatol2021 Feb 01; 48
AB  - Objective. To assess pulmonary function and chronic obstructive pulmonary disease (COPD) development over time in patients with primary Sjögren syndrome (pSS), as well as the association between pulmonary function, radiographic findings, respiratory symptoms, and clinical features of pSS, taking cigarette consumption into account.Methods. Forty patients with pSS (mean age 66 yrs; range 42–81 yrs; 39 women), previously participating in a cross-sectional study on pulmonary involvement in pSS, were reassessed by pulmonary function tests after a mean follow-up time of 6 years. At follow-up, patients were also assessed by high-resolution computed tomography of the chest, as well as for pSS disease activity, respiratory symptoms, and cigarette consumption.Results. Patients with pSS showed significantly decreased percentages of predicted total lung capacity (TLC), residual volume (RV), RV/TLC ratio, and diffusing capacity of the lungs for carbon monoxide, as well as an increase in predicted forced expiratory volume in 1 second/vital capacity (FEV1/VC) ratio from baseline to follow-up. The proportion of COPD in patients with pSS did not change significantly from baseline to follow-up (38% vs 40%, respectively). Radiographic signs of bronchial involvement and interstitial lung disease were each found in 38% of the patients.Conclusion. Both airway and pulmonary parenchymal disease were commonly found in patients with pSS, with a coexistence of both an obstructive and restrictive pulmonary function pattern, where the latter tended to deteriorate over time. COPD was a common finding. Airway and pulmonary involvement may be underdiagnosed in pSS, which is why special attention to clinical assessment of pulmonary involvement in patients with pSS is mandated.