Relationship between esophageal motility abnormalities and skin or lung involvements in patients with systemic sclerosis
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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.
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.
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.
There were significant correlations between EMAs and severe skin thickness. GERD is not an etiology of ILDs.
KeywordsSystemic sclerosis Esophageal motility abnormalities Gastroesophageal reflux disease Interstitial lung disease
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).
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.
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.
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