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

  • Shiko KuribayashiEmail author
  • Sei-ichiro Motegi
  • Kenichiro Hara
  • Yasuyuki Shimoyama
  • Hiroko Hosaka
  • Akiko Sekiguchi
  • Kouichi Yamaguchi
  • Osamu Kawamura
  • Takeshi Hisada
  • Osamu Ishikawa
  • Motoyasu Kusano
  • Toshio Uraoka
Original Article—Alimentary Tract
  • 73 Downloads

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.

Keywords

Systemic sclerosis Esophageal motility abnormalities Gastroesophageal reflux disease Interstitial lung disease 

Notes

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).

Author 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.

Funding

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

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 19 kb)
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Supplementary material 2 (DOCX 18 kb)
535_2019_1578_MOESM3_ESM.docx (18 kb)
Supplementary material 3 (DOCX 17 kb)

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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  • Shiko Kuribayashi
    • 1
    • 2
    Email author
  • Sei-ichiro Motegi
    • 3
  • Kenichiro Hara
    • 4
  • Yasuyuki Shimoyama
    • 2
  • Hiroko Hosaka
    • 2
  • Akiko Sekiguchi
    • 3
  • Kouichi Yamaguchi
    • 4
  • Osamu Kawamura
    • 2
  • Takeshi Hisada
    • 4
  • Osamu Ishikawa
    • 3
  • Motoyasu Kusano
    • 2
  • Toshio Uraoka
    • 2
  1. 1.Clinical Investigation and Research UnitGunma University HospitalMaebashiJapan
  2. 2.Division of Gastroenterology and Hepatology, Integrative Center of Internal MedicineGunma University HospitalMaebashiJapan
  3. 3.Department of DermatologyGunma University Graduate School of MedicineMaebashiJapan
  4. 4.Allergy and Respiratory Medicine, Integrative Center of Internal MedicineGunma University HospitalMaebashiJapan

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