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Vol. 17. Issue 3.
Pages 144-149 (March 2021)
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Vol. 17. Issue 3.
Pages 144-149 (March 2021)
Original Article
DOI: 10.1016/j.reumae.2019.05.004
Subclinical interstitial lung disease in patients with systemic sclerosis. A pilot study on the role of ultrasound
Intersticiopatía pulmonar subclínica en pacientes con esclerosis sistémica. Estudio piloto sobre el papel del ultrasonido
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Samuel Reyes-Longa, Marwin Gutierrezb,
Corresponding author
dr.gmarwin@gmail.com

Corresponding author.
, Denise Clavijo-Cornejoa, Alfonso Alfaro-Rodrígueza, Karen González-Sámanoa, José Luis Cortes-Altamiranoa, Roberto Muñoz-Louisc, Esteban Cruz-Arenasa, Katia Camargoa, Fernanda Gonzaleza, Chiara Bertolazzia
a Instituto Nacional de Rehabilitación, Mexico City, Mexico
b Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Iztapalapa, Mexico City, Mexico
c Hospital Docente Padre Billini, Grupo ERIC, Santo Domingo, Dominican Republic
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Figures (2)
Tables (3)
Table 1. Demographic data of the population studied.
Table 2. Association between US signs-ILD and variables.
Table 3. Sensitivity, specificity, predictive values and area under the ROC curve.
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Abstract
Introduction

Interstitial lung disease (ILD) is a common comorbidity present in patients with systemic sclerosis (SSc). Employment of high-resolution computed tomography (HRCT) is very limited and lung ultrasound (LUS) can be an alternative tool for the early evaluation of ILD.

Objective

To determine the validity of LUS in the early detection of ILD in patients with SSc.

Materials and Methods

Sixty-eight patients with SSc ≥18 years without respiratory symptoms were included. A rheumatologist rated the subclinical respiratory condition, another rheumatologist blinded to the clinical assessment performed the LUS. To determine validity HRCT was performed as well.

Results

Prevalence of LID in SSc patients was 41.2% in contrast to the 4.8% healthy controls (P = .0001). Variables associated with LUS and HRCT findings were anti-centromere antibodies (P = .005) and the Rodnan skin score (P = .004). A positive correlation was present between the findings of HRCT and LUS (P = .001). Sensitivity and specificity were 91.2% and 88.6% respectively. Good reliability in the LUS findings was found between observers (k = .72).

Conclusion

By proving to be a valid, trustworthy and feasible alternative tool, we consider that LUS can be implemented for the early detection of ILD in SSc.

Keywords:
Systemic sclerosis
Lung ultrasound
Interstitial lung disease
Resumen
Introducción

La enfermedad pulmonar intersticial (EPI) es una complicación común de la esclerosis sistémica (ES). El empleo de la tomografía computarizada de alta resolución (TACAR) se ve muy limitado y el ultrasonido pulmonar (USP) puede ser un instrumento alternativo para la evaluación de la EPI.

Objetivo

Determinar la validez del US pulmonar en la detección temprana de la EPI en pacientes con ES.

Métodos

Se incluyeron 68 pacientes con ES ≥ 18 años sin síntomas respiratorios. Un reumatólogo valoró el estado respiratorio subclínico, otro reumatólogo, cegado a la evaluación clínica realizó el USP. Para determinar la validez concurrente se realizó una TACAR.

Resultados

Un 41,2% de pacientes mostraron EPI por USP a diferencia de los controles sanos (4,8%) (p = 0,0001). Las variables asociadas con los hallazgos de EPI al USP fueron anticuerpos anti-centrómero (p = 0,005) y la puntuación de piel RSS (p = 0,004). Se encontró una correlación positiva entre los hallazgos de EPI por USP y TACAR (p = 0,001). La sensibilidad fue del 91.2% y la especificidad de 88,6%. Una buena confiabilidad entre observadores de los hallazgos por USP fue observada (k = 0,72).

Conclusiones

Al ser una herramienta alternativa válida, confiable y factible, consideramos que el USP puede ser implementado para la detección temprana de EPI en ES.

Palabras clave:
Esclerosis sistémica
Ultrasonido pulmonar
Enfermedad pulmonar intersticial

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