title: Assessment of interstitial lung disease in Sjögren's syndrome by lung ultrasound: a pilot study of correlation with high-resolution chest tomography.
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.
authors.affiliation: Internal Medicine Department, Complejo Hospitalario Ruber Juan Bravo, European University, Juan Bravo Street 39-49, 28006, Madrid, Spain. pablogvasco@gmail.com.
authors.forename: Pablo Guisado
authors.identifier: http://orcid.org/0000-0003-3019-4398
authors.initials: PG
authors.lastname: Vasco
authors.affiliation: Médecine Interne, Hôpital Européen Georges-Pompideu, 20 Rue Leblanc, 75015, Paris, France.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: de Luna Cardenal
authors.affiliation: Internal Medicine Department, Complejo Hospitalario Ruber Juan Bravo, European University, Juan Bravo Street 39-49, 28006, Madrid, Spain.
authors.forename: Isabel Martín
authors.initials: IM
authors.lastname: Garrido
authors.affiliation: Internal Medicine Department, Complejo Hospitalario Ruber Juan Bravo, European University, Juan Bravo Street 39-49, 28006, Madrid, Spain.
authors.forename: José Manuel Luque
authors.initials: JM
authors.lastname: Pinilla
authors.affiliation: Internal Medicine, University Hospital Ramón y Cajal, Colmenar Viejo Road km 9.1, 28034, Madrid, Spain.
authors.forename: Guadalupe Fraile
authors.initials: GF
authors.lastname: Rodríguez
authors.affiliation: Internal Medicine, University Hospital Ramón y Cajal, Colmenar Viejo Road km 9.1, 28034, Madrid, Spain.
authors.forename: Juan José Nava
authors.initials: JJ
authors.lastname: Mateo
authors.affiliation: Internal Medicine Department, University Hospital Quiron, European University, Diego de Velazquez St, 1, Pozuelo de Alarcón, 28223, Madrid, Spain.
authors.forename: Daniel Carnevalli
authors.initials: DC
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000002:abnormalities; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data
keywords: CT scanning; Diagnostic imaging; Disease activity; Respiratory; Sjögren’s syndrome; Ultrasonography