Abstract

A STUDY OF PLEURO-PULMONARY MANIFESTATIONS IN SYSTEMIC SCLEROSIS - HOSPITAL BASED OBSERVATIONAL STUDY

Author(s): G. Bhaskar, D. Nehru, V. P. Kannan

BACKGROUND Systemic sclerosis (SSC) is a chronic multisystem disorder of unknown aetiology characterized clinically by thickening of the skin caused by accumulation of connective tissue and by involvement of visceral organs, including the gastrointestinal tract, lungs, heart and kidneys. The annual incidence of systemic sclerosis occurs at a rate of 2 per million population per year. The prevalence of systemic sclerosis is 50 per 1,00,000 population. The objectives of the study were- to detect pleuropulmonary involvement in systemic sclerosis patients by clinical examination and investigations including x-ray chest, high resolution computerized tomography, pulmonary function test, electrocardiograph, and echocardiogram with Doppler study of pulmonary arterial pressure and to analyse the incidence of various types of pulmonary manifestations. MATERIALS AND METHODS This is a hospital based prospective observational study conducted in Thanjavur Medical College. About 22 patients who were diagnosed as systemic sclerosis were enrolled in the study between January 2017 to December 2017. The pleuro-pulmonary manifestations are analysed both clinically and radiologically and results were studied in detail. RESULTS The incidence of pulmonary involvement in SSC was significantly high in study and the pattern of involvement were interstitial lung disease being the most common followed by parenchymal lung lesion and pleural involvement as pleural thickening and effusion. The most common symptoms were unproductive cough and non-specific chest pain and effort dyspnoea. Most of the above symptoms were found in combination in the same patients. Chest x-rays, PFT, HRCT Procedures were used, and HRCT happens to be having the highest sensitivity rate even more than the PFT among the 3 diagnostic methods. CONCLUSION The incidence of Pulmonary involvement in SSC was significantly high in study and the pattern of involvement were interstitial lung disease being the most common followed by parenchymal lung lesion and pleural involvement as pleural thickening and effusion. The most common symptoms were unproductive cough and chest pain which were not specific and effort dyspnoea. Most of the above Symptoms were found in combination in the same patients. Chest x-rays, PFT, HRCT Procedures were used, and HRCT happens to be having the highest sensitivity rate even more than the PFT among the 3 diagnostic methods. To conclude, the pleuropulmonary involvement was significantly high and almost all the findings concur with that as found in the literature and still more facts can come to light with the use of advanced measures like immunological study.