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Relationship between esophageal motility abnormalities and skin or lung involvements in patients with systemic sclerosis

  • Original Article—Alimentary Tract
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Abstract

Background

Esophageal motility abnormalities (EMAs) and interstitial lung diseases (ILDs) are often seen in patients with systemic sclerosis (SSc). Gastroesophageal reflux disease (GERD) could be associated with ILDs, but it is not fully understood if ILDs are caused by GERD or SSc itself.

Methods

A total of 109 patients with SSc who underwent high-resolution manometry were enrolled. Esophageal motility was diagnosed with the Chicago classification v3.0. The severity of skin thickness was evaluated by the modified Rodnan total skin thickness score (mRSS). The severity of ILDs was assessed with the chest high-resolution computer tomography (HRCT) scoring system. Relationships between EMAs, GERD, autoantibodies, skin thickness and ILDs were evaluated.

Results

44 patients had normal esophageal motility, eight had esophago-gastric junction outflow obstruction, one had distal esophageal spasm, 27 had ineffective esophageal motility and 29 had absent contractility (AC). Patients with AC had more GERD than those with normal esophageal motility (p < 0.05). The mRSS score in patients with AC was significantly higher than that in those with normal esophageal motility (p < 0.05). The HRCT score in patients with AC tended to be higher than that in those with normal esophageal motility (p = 0.05). A multivariable analysis showed that severe skin thickness was a significant predictor of AC. GERD was not a significant predictor for ILDs.

Conclusions

There were significant correlations between EMAs and severe skin thickness. GERD is not an etiology of ILDs.

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Acknowledgements

The authors thank Prof. Kunihiko Hayashi and Prof. Mitsuo Uchida who contributed statistical analyses. The English language was reviewed by a native English speaker (NAI Inc., Tokyo, Japan).

Funding

This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI for Early Career Scientists Grant Number JP18K15772.

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Authors and Affiliations

  1. Clinical Investigation and Research Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Shiko Kuribayashi

  2. Division of Gastroenterology and Hepatology, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Japan

    Shiko Kuribayashi, Yasuyuki Shimoyama, Hiroko Hosaka, Osamu Kawamura, Motoyasu Kusano & Toshio Uraoka

  3. Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan

    Sei-ichiro Motegi, Akiko Sekiguchi & Osamu Ishikawa

  4. Allergy and Respiratory Medicine, Integrative Center of Internal Medicine, Gunma University Hospital, Maebashi, Japan

    Kenichiro Hara, Kouichi Yamaguchi & Takeshi Hisada

Authors
  1. Shiko Kuribayashi
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  2. Sei-ichiro Motegi
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  3. Kenichiro Hara
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  4. Yasuyuki Shimoyama
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  5. Hiroko Hosaka
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  10. Osamu Ishikawa
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  11. Motoyasu Kusano
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  12. Toshio Uraoka
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Contributions

SK is responsible for study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, statistical analysis, obtained funding. SM and KH are responsible for study concept and design, acquisition of data, interpretation of data, and critical revision of the manuscript. YS, HH, AS and KY are responsible for acquisition of data. OK, MK, TH, OI and TU are responsible for study supervision.

Corresponding author

Correspondence to Shiko Kuribayashi.

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Kuribayashi, S., Motegi, Si., Hara, K. et al. Relationship between esophageal motility abnormalities and skin or lung involvements in patients with systemic sclerosis. J Gastroenterol 54, 950–962 (2019). https://doi.org/10.1007/s00535-019-01578-6

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  • DOI: https://doi.org/10.1007/s00535-019-01578-6

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