PULMONARY FINDINGS IN PATIENTS WITH PRIMARY SJOGRENS-SYNDROME

Study objective: To evaluate pulmonary findings in patients with prima ry Sjogren's syndrome (SS). Design: Prospective data collection. Patie nts: Seventeen consecutive nonsmoking patients with primary SS. Measur ements and results: Mild radiologic parenchymal changes were seen in t wo patients, Pulmonary hyperinflation (residual volume/total lung capa city [RV/TLC] percent ratio measured minus [-] RV/TLC percent ratio pr edicted greater than or equal to 8) was observed in 9 (53%) patients, whereas obstructive and restrictive changes were infrequently found in ordinary spirometry (FVC, FEV(1), FEV%) (none and two cases, respecti vely). Patients with SS with hyperinflation had significantly lower ma ximal expiratory flow MEF50 (<0.05), MEF25 (p<0.05), and higher total lung capacity (p<0.05) and FRC (p<0.05) values as compared with those patients with SS without hyperinflation, They were also more frequentl y dyspnoeic (six vs none, p<0.02) and had higher mean serum B-2-microg lobulin levels (3.6+/-1.0 mg/L vs 2.6+/-0.7 mg/L, p<0.025). The levels of serum beta(2)-microglobulin correlated inversely with FVC (r=-0.58 3, p<0.01), FEV(1) (r=-0.533, p<0.05), diffusing capacity for carbon m onoxide (r=-0.580, p<0.01); its correlation with RV/TLC percent ratio was positive and relatively significant (r=0.447, 0.05< p<0.10). Concl usions: Pulmonary hyperinflation associated with diminished peripheral spirometric flow values is frequently found in patients with primary SS, This together with the correlation of disturbed lung function para meters to elevated serum Pz-microglobulin levels suggests that lungs a nd especially small airways may be an usual target organ in primary SS .