title: Esophageal hypomotility in systemic sclerosis: close relationship with pulmonary involvement.
abstract: OBJECTIVE
  Esophageal motility was assessed in patients with systemic sclerosis (SSc) by scintigraphy and compared with (i) extent of scleroderma, (ii) duration of disease, (iii) index of anti-topoisomerase I antibody (topo I), and (iv) pulmonary involvement.
  
  
  METHODS
  A multiple-swallow test was performed in 47 patients with SSc in the supine position with 99mTc-DTPA. A region of interest on the entire esophagus was defined and the retention ratio (RR) was calculated from a time-activity curve.
  
  
  RESULTS
  Patients with diffuse scleroderma had higher RRs than those with limited scleroderma (48.8% vs. 30.0%; p < 0.05). There was no correlation between the RRs and the duration of disease. Patients with positive topo I had higher RRs than those who were negative (53.8% vs. 29.7%; p < 0.05). Patients with reduced % diffusion capacity for carbon monoxide (%DLCO) had higher RRs than those with normal %DLCO (40.5% vs. 19.6%; p = 0.03). Patients with reduced % vital capacity (%VC) had higher RRs than those with normal %VC (54.6% vs. 25.0%; p < 0.005). Patients with pulmonary fibrosis had higher RRs than those who were negative (58.5% vs. 20.3%; p < 0.00005).
  
  
  CONCLUSIONS
  Esophageal dysfunction in patients with SSc showed a correlation with the extent of scleroderma, positive topo I, and pulmonary involvement. The RR can be an objective clinical marker for the severity of organ fibrosis.
authors.affiliation: Department of Radiology, Tonami General Hospital, Toyama, Japan. dinky@d9.dion.ne.jp
authors.forename: K
authors.initials: K
authors.lastname: Kinuya
authors.forename: K
authors.initials: K
authors.lastname: Nakajima
authors.forename: S
authors.initials: S
authors.lastname: Kinuya
authors.forename: T
authors.initials: T
authors.lastname: Michigishi
authors.forename: N
authors.initials: N
authors.lastname: Tonami
authors.forename: K
authors.initials: K
authors.lastname: Takehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D004264:DNA Topoisomerases, Type I / Q000276:immunology; D015154:Esophageal Motility Disorders / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging* / Q000276:immunology; D016284:Technetium Tc 99m Pentetate; D014797:Vital Capacity
chemical_list: D001323:Autoantibodies; D019275:Radiopharmaceuticals; D004264:DNA Topoisomerases, Type I; D016284:Technetium Tc 99m Pentetate