Esophageal hypomotility in systemic sclerosis: close relationship with pulmonary involvement.
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.
Kinuya
K
K
Department of Radiology, Tonami General Hospital, Toyama, Japan. dinky@d9.dion.ne.jp
Nakajima
K
K
Kinuya
S
S
Michigishi
T
T
Tonami
N
N
Takehara
K
K
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
D001323:Autoantibodies; D019275:Radiopharmaceuticals; D004264:DNA Topoisomerases, Type I; D016284:Technetium Tc 99m Pentetate