Correlation of Esophageal Dilatation and Pulmonary Fibrosis in Scleroderma

SESSION TITLE: Connective Tissue-Associated Interstitial Lung Disease SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: Pulmonary fibrosis has been reported to occur in 25-90% of patients with systemic scleroderma with a lower prevalence of 12-39% in limited scleroderma. The cause of this fibrosis is presumed to be post-inflammatory. However, because of the presence of esophageal dysmotility in scleroderma, there is a possibility of aspiration resulting in fibrosis. If this were the case, the worse the esophageal dilatation, the more extensive would be the fibrosis. The objective of our study was to determine if there is a correlation between esophageal dilatation (measured by the esophageal diameter and extent of pulmonary fibrosis (estimated by fibrosis score from high resolution CT [HRCT] of chest) in patients with scleroderma. METHODS: The records of 74 patients with scleroderma followed at our institution were reviewed. Patient demographics and type of scleroderma (systemic vs. limited) were noted. Esophageal diameter was determined from HRCT by averaging measurements at 3 levels- at the middle of the aortic arch, 2 cm below the carina and just above the diaphragm. Studied variables were expressed as mean ± SD. Patients’ chest HRCT scans were graded by a radiologist for ILD by a fibrosis score, calculated by estimating the percentage of parenchymal involvement in three zones (upper, middle, lower) of each lung, with a score of 100 representing normal and a score of 400 representing severe fibrosis. Pearson’s correlation test was used to determine the association between esophageal diameter and fibrosis score. p< 0.05 was deemed statistically significant. RESULTS: Mean age was 57.5 ± 12.7 years; 66% were females; majority of the studied patients (76%) had limited disease. Mean esophageal diameter was 13.9 ± 4.4 mm. Mean fibrosis score was: 109 ± 27mm. Using Pearson’s test for linear correlation, there was no significant correlation between esophageal diameter and fibrosis score (r = 0.052; p = 0.7) in the studied patients. CONCLUSIONS: There is no significant correlation between esophageal diameter and extent of pulmonary fibrosis in limited scleroderma. CLINICAL IMPLICATIONS: Esophageal diameter does not predict interstitial lung disease in limited scleroderma DISCLOSURE: The following authors have nothing to disclose: Vanessa Yap, Massa Zantah, Adarsha Selvachandran, Pardeep Athwal, Electra Kaloudis, Debapriya Datta, Raymond Foley No Product/Research Disclosure Information