Pulmonary function in children affected by juvenile spondyloarthropathy

Objective, Pleuropulmonary involvement in adult spondyloarthropathy (SpA) h as been thoroughly investigated. SpA is usually detected by conventional ra diology as fibrosis of the upper lobes in about 30% of asymptomatic patient s. Pulmonary function tests (PFT) reveal decreased vital capacity and total lung capacity, as well as increased residual volume. Juvenile SpA (JSpA) i s a rare clinical condition, and no extensive investigations have been carr ied out on pulmonary involvement in JSpA. We studied prevalence and feature s of PFT alterations in patients with JSpA over a 2 year followup and analy zed the relationship between PFT and disease duration, disease activity, an d chest and spine mobility. Methods. Eighteen patients with JSpA, with no clinical signs of lung diseas e and normal chest radiographs, underwent PFT - static and dynamic volumes, diffusing capacity for carbon monoxide (DLCO), at enrollment (TO), at 12 m onths (T1), and at 24 months later (T2). Disease activity was defined at ea ch investigation by clinical and hematological data. Results. Significant functional lung impairment was detected in 33% of pati ents (reduced forced vital capacity in 22% and DLCO in 11%). No significant change in the prevalence and features of PFT alterations was detected at T 1 and T2; no relationship was found between PFT and duration, activity, and clinical scores of the disease. Conclusion. Thirty-three percent of JSpA patients without clinical symptoms and no radiological findings of lung involvement show PFT alterations, mai nly characterized by a restrictive pattern. No progression or modification in PFT developed over 2 years. No correlation was found between PFT and dis ease duration, activity, and clinical scores.