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Assessment of interstitial lung disease in Sjögren’s syndrome by lung ultrasound: a pilot study of correlation with high-resolution chest tomography

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Abstract

The background of this study is to assess the accuracy of lung ultrasound (LUS) to diagnose interstitial lung disease (ILD) in Sjögren’s syndrome (Sjs), in patients who have any alterations in pulmonary function tests (PFT) or respiratory symptoms. LUS was correlated with chest tomography (hrCT), considering it as the imaging gold standard technique to diagnose ILD. This is a pilot, multicenter, cross-sectional, and consecutive-case study. The inclusion criteria are ≥18 years old, Signs and symptoms: according to ACEG 2002 criteria, respiratory symptoms (dyspnea, cough), or any alterations in PFR. LUS was done following the International Consensus Conference on Lung Ultrasound protocol for interstitial syndrome (B pattern). Of the 50 patients in follow-up, 13 (26%) met the inclusion criteria. All were women with age 63.62 years (range 39–88). 78.6% of the cases had primary Sjs (SLE, RA, n = 2). The intra-rater reliability k is 1, according to Gwet’s Ac1 and GI index (probability to concordance—e(K)—, by Cohen, of 0.52). LUS has a sensitivity of 1 (95% CI 0.398–1.0), specificity of 0.89 (95% CI 0.518–0.997), and a positive probability reason of 9.00 (95% CI 7.1–11.3) to detect ILD. The correlation of Pearson is r = 0.84 (p < 0.001). To check the accuracy of LUS to diagnose ILD, a completely bilateral criterion of yes/no for interstitial pattern was chosen, AUC reaches significance, 0.94 (0.07) (95% CI 0.81–1.0, p = 0.014). LUS reaches an excellent correlation to hrCT in Sjs affected with ILD, and might be a useful technique in daily clinical practice for the assessment of pulmonary disease in the sicca syndrome.

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Authors and Affiliations

  1. Internal Medicine Department, Complejo Hospitalario Ruber Juan Bravo, European University, Juan Bravo Street 39–49, 28006, Madrid, Spain

    Pablo Guisado Vasco, Isabel Martín Garrido & José Manuel Luque Pinilla

  2. Médecine Interne, Hôpital Européen Georges-Pompideu, 20 Rue Leblanc, 75015, Paris, France

    Gonzalo de Luna Cardenal

  3. Internal Medicine, University Hospital Ramón y Cajal, Colmenar Viejo Road km 9.1, 28034, Madrid, Spain

    Guadalupe Fraile Rodríguez & Juan José Nava Mateo

  4. Internal Medicine Department, University Hospital Quiron, European University, Diego de Velazquez St, 1, Pozuelo de Alarcón, 28223, Madrid, Spain

    Daniel Carnevalli Ruiz

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  1. Pablo Guisado Vasco
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  2. Gonzalo de Luna Cardenal
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  3. Isabel Martín Garrido
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  7. Daniel Carnevalli Ruiz
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Correspondence to Pablo Guisado Vasco.

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Conflict of interest

None of the authors have received any founding or grant for the preparation of this manuscript. They have no commercial interests or intellectual property in any drug, device, or medical equipment mentioned in this article. All authors meet criteria for authorship, and will sign a statement attesting authorship, disclosing all potential conflicts of interest, and releasing the copyright should the manuscript be acceptable for publication. This manuscript has been read and approved by all the authors.

Sponsor

GE Healthcare has given us one of the ultrasonic devices as part of a campaign of training in the use of clinical ultrasound. None of the authors have received any grant, funding, or monetary compensation nor had other financial relationship with the above-mentioned company.

Statement of human and animal rights

The local ethics committee of each center approved the protocol.

Informed consent

An informed consent was obtained from all the patients enrolled in the study.

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Vasco, P.G., de Luna Cardenal, G., Garrido, I.M. et al. Assessment of interstitial lung disease in Sjögren’s syndrome by lung ultrasound: a pilot study of correlation with high-resolution chest tomography. Intern Emerg Med 12, 327–331 (2017). https://doi.org/10.1007/s11739-016-1582-8

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  • DOI: https://doi.org/10.1007/s11739-016-1582-8

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