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Rheumatology International

, Volume 7, Issue 1, pp 23–27 | Cite as

Esophageal manometric findings in autoimmune rheumatic diseases: is scleroderma esophagus a specific entity?

  • E. B. Tsianos
  • A. A. Drosos
  • C. D. Chiras
  • H. M. Moutsopoulos
  • R. C. Kitridou
Originals

Summary

In order to assess whether distal esophageal hypomotility in scleroderma is unique to this disease or not, we studied 25 normal volunteers and 109 patients with autoimmune rheumatic diseases (27 with primary Sjögren's syndrome, 25 with idiopathic Raynaud's phenomenon, 25 with rheumatoid arthritis, 19 with scleroderma, 5 with undifferentiated connective tissue disease, 3 with systemic lupus erythematosus, 2 with mixed connective tissue disease, 2 with sclerodermatomyositis, and one with morphea). Esophageal dysfunction typical of scleroderma was present in 17 patients (15.6%), of whom 13 had scleroderma (68%) and one each primary Sjögren's syndrome, rheumatoid arthritis, undifferentiated connective tissue disease, and mixed connective tissue disease. Twenty-two percent of all patients had nonspecific esophageal motility changes, clustered among primary Sjögren's syndrome, idiopathic Raynaud's phenomenon, and rheumatoid arthritis. We conclude that lower esophageal hypomotility, although most frequent in scleroderma, is not unique to this disease and can be encountered in several other autoimmune rheumatic diseases.

Key words

Scleroderma Sjögren's syndrome Esophageal dysmotility Esophageal manometry Idiopathic Raynaud's phenomenon Rheumatoid arthritis 

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References

  1. 1.
    Creamer B, Anderson HA, Code CF (1956) Esophageal motility in patients with scleroderma and related diseases. Gastroenterologia (Basel) 86:763–775Google Scholar
  2. 2.
    Atkinson M, Summerling MD (1966) Oesophageal changes in systemic sclerosis. Gut 7:402–408Google Scholar
  3. 3.
    Cohen S, Fisher R, Lipshutz W, Turner R, Myers A, Schumacher HR (1972) The pathogenesis of esophageal dysfunction in scleroderma and Raynaud's disease. J Clin Invest 51:2663–2668Google Scholar
  4. 4.
    Weihrauch TR, Korting GW, Ewe K, Vogt G (1978) Esophageal dysfunction and its pathogenesis in progressive systemic sclerosis. Klin Wochenschr 56:963–968Google Scholar
  5. 5.
    Poirier TJ, Rankin GB (1972) Gastrointestinal manifestations of progressive systemic scleroderma based on a review of 364 cases. Am J Gastroenterol 58:30–44Google Scholar
  6. 6.
    Stevens MB, Hookman P, Siegel CL, Esterly JR, Schulman LE, Hendrix TR (1964) Aperistalsis of the esophagus in patients with connective tissue disorders and Raynaud's phenomenon. N Engl J Med 270:1218–1222Google Scholar
  7. 7.
    De Merieux P, Verity MA, Clements PJ, Paulus HE (1983) Esophageal abnormalities and dysphagia in polymyositis and dermatomyositis. Clinical, radiographic and pathologic features. Arthritis Rheum 26:961–968Google Scholar
  8. 8.
    Gutierrez F, Valenzuela JE, Ehresmann GR, Quismorio FP, Kitridou RC (1982) Esophageal dysfunction in patients with mixed connective tissue diseases and systemic lupus erythematosus. Dig Dis Sci 27:592–597Google Scholar
  9. 9.
    Schneider HA, Yonker RA, Longley S, Katz P, Mathias J, Panush RS (1984) Scleroderma esophagus: a nonspecific entity. Ann Intern Med 100:848–850Google Scholar
  10. 10.
    Moutsopoulos HM, Chused TM, Mann DL, Klippel JH, Fauci AS, Frank MM, Lawley TJ, Hamburger MI (1980) Sjögren's syndrome (sicca syndrome): current issues. Ann Intern Med 92:212–226Google Scholar
  11. 11.
    Moutsopoulos HM, Constantopoulos SH, Gerber LH, Lawley TJ (1983) Immunologic abnormalities in idiopathic Raynaud's phenomenon. Clin Exp Rheumatol 1:45–48Google Scholar
  12. 12.
    Ropes MW, Bennett GA, Cobb S, Jacox R, Jessar RA (1958) Revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 9:175–176Google Scholar
  13. 13.
    Masi AT, Rodnan GP, Medsger TA Jr, Altman RD, D'Angelo WA, Fries JF, LeRoy EC, Kirsner AB, Mackenzie AH, McShane DJ, Myers AR, Sharp GC (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590Google Scholar
  14. 14.
    Winterbauer RH (1964) Multiple telangiectasia, Raynaud's phenomenon, sclerodactyly and subcutaneous calcinosis: a syndrome mimicking hereditary telangiectasia. Bull John's Hopkins Hosp 114:361–364Google Scholar
  15. 15.
    Sharp GC, Irvin WS, Tan EM, Gould RG, Holman HR (1972) Mixed connective tissue disease — an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med 52:148–159Google Scholar
  16. 16.
    Tan EM, Cohen AS, Fries JF, Masi AT, McShane PJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277Google Scholar
  17. 17.
    LeRoy EC, Maricq HR, Kahaleh MB (1980) Undifferentiated connective tissue syndromes. Arthritis Rheum 23:341–343Google Scholar
  18. 18.
    Bohan A, Peter JB (1975) Polymyositis and dermatomyositis. N Engl J Med 292:344–347Google Scholar
  19. 19.
    Dodds WJ, Hogan WJ, Reid DP, Stewart ET, Arndorfer RC (1973) A comparison between primary esophageal peristalsis following wet and dry swallows. J Appl Physiol 35:851–857Google Scholar
  20. 20.
    Tsianos EB, Chiras CD, Drosos AA, Moutsopoulos HM (1985) Oesophageal dysfunction in patients with primary Sjögren's syndrome. Ann Rheum Dis 44:610–613Google Scholar
  21. 21.
    Velayos EE, Robinson H, Ponciuncula FU, Masi AT (1971) Clinical correlation analysis of 137 patients with Raynaud's phenomenon. Am J Med Sci 262:347–356Google Scholar
  22. 22.
    Hogan WJ, Dodds WJ, Stewart ET (1973) Comparison of roentgenology and intraluminal manometry for evaluating esophageal peristalsis. Rend Gastroenterol 5:28Google Scholar
  23. 23.
    Krejs GS, Lobsiger M, Rau R, Bran B, Van Buren U, Peter P, Brandii H, Pirozynski W, Blum AL (1976) Esophageal function in progressive systemic sclerosis. Acta Hepato-Gastroenterol 23:40–46Google Scholar
  24. 24.
    Dodds WJ (1977) Current concepts of esophageal motor function: clinical implications for radiology. AJR 128:549–561Google Scholar
  25. 25.
    Nimelstein SH, Brody S, McShane D, Holman HR (1980) Mixed connective tissue disease: a subsequent evaluation of the original 25 patients. Medicine 59:239–250Google Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • E. B. Tsianos
    • 1
  • A. A. Drosos
    • 1
  • C. D. Chiras
    • 1
  • H. M. Moutsopoulos
    • 1
  • R. C. Kitridou
    • 2
  1. 1.Department of Medicine, Medical SchoolUniversity of IoanninaIoanninaGreece
  2. 2.School of MedicineUniversity of Southern CaliforniaLos AngelesUSA

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