Bronchiectasis in systemic sclerosis. A study using high resolution computed tomography

Objective. To detect noninvasively the presence of bronchiectasis in patien ts with systemic sclerosis (SSc), through the use Of high resolution chest computed tomography (HRCT). Methods. Twenty two patients with SSc, of whom 13 with diffuse and 9 writ l imited disease, besides a complete history: physical and routine laboratory and immunologic profile, were evaluated by pulmonary function testing and HRCT The chi square test with Yates' correction, the Fishery exact test, th e Fisher's test (F test) and the "t" test were used for statistical analysi s of the results. Results. Eleven patients (50.0%) had decreased carbon monoxide diffusing lu ng capacity (DLCO) and, ou of these, four had restrictive lung disease, bas ed on a combined decrease of forced vital capacity (FVC) and total lung cap acity (TLC). Another two Patients exhibited this pattern without DLCO impai rment. HRCT revealed a ground glass picture in 15 patients (68.2%), fibrosi s in 9 (40.9%) (of which 5 with ground glass as well), and cylindrical bron chiectasis in 13 (59.1%). Bronchiectasis M as more common in diffuse than i n limited SSc, and the difference approached bur did not reach the level of statistical significance. On the other hand it was not correlated with eit her decreased DLCO, presence of ground glass and fibrosis, or with patients ' age and disease duration. Conclusion. Although the number of patients included in our study is relati vely small, our data, for the first time in the literature, indicate a sign ificant association between scleroderma and bronchiectasis. Bronchiectasis should he included in the list of pulmonary manifestations of SSc, and SSc in the list of conditions causing bronchiectasis.