Esophageal hypomotility in systemic sclerosis: Close relationship with pulmonary involvement

Purpose: Esophageal motility was assessed in patients with systemic scleros is (SSc) by scintig raphy and compared with (i) extent of scleroderma, (ii) duration of disease, (iii) index of antitopoisomerase I antibody (topo I), and (iv) pulmonary involvement. Methods: A multiple-swallow test was perfo rmed in 47 patients with SSc in the supine position with Tc-99m-DTPA. A reg ion of interest on the entire esophagus was defined and the retention ratio (RR) was calculated From a timeactivity curve. Results: Patients with diff use scleroderma had higher RRs than those with limited scleroderma (48.8% v s. 30.0%; p < 0.05). There was no correlation between the RRs and the durat ion of disease. Patients with positive topo I had higher RRs than those who were negative (53.8% vs. 29.7%; p < 0.05), Patients with reduced % diffusi on capacity for carbon monoxide (%,DLCO) had higher RRs than those with nor mal %DLCO (40.5% vs. 19.6%; p = 0.03). Patients with reduced Ic vital capac ity (%VC) had higher RRs than those with normal %VC (54,64% vs. 25.0%; p < 0.005). Patients with pulmonary fibrosis had higher RRs than those: who wer e negative (58.5% vs. 20.3%; p < 0.00005). Conclusion: Esophageal dysfuncti on in patients with SSc showed a correlation with the extent of scleroderma , positive topo I, and pulmonary involvement. The RR can be an objective cl inical marker for the severity of organ fibrosis.