Chest
Original ResearchHigh-Resolution CTHigh-Resolution CT Scan Findings in Patients With Symptomatic Scleroderma-Related Interstitial Lung Disease
Section snippets
Patients
The SLS was a prospective, randomized, double-blinded, controlled clinical trial that evaluated the effectiveness of oral cyclophosphamide vs placebo therapy in the treatment of active, symptomatic pulmonary alveolitis inflammation secondary to systemic sclerosis.12 Institutional board approval was obtained at all 13 clinical centers; informed consent and Health Insurance Portability and Accountability Act compliance were obtained from all participants recruited over a period of 3 to 4 years.
Patient Characteristics
Of the 267 subjects screened for eligibility, 162 were SLS randomized, including 114 female subjects and 46 male subjects. The mean (± SD) age was 51 ± 12.3 years; 40% of subjects (65 of 162 subjects) had lcSSc, and 60% of subjects (97 of 162 subjects) had dcSSc (Table 2). A total of 79 subjects were randomized to the placebo control group. Of the 105 screened-eligible subjects who failed randomization (for a variety of reasons), 68 underwent HRCT scanning and 53 underwent BAL. Figure 5
Discussion
This study confirms that thoracic HRCT scanning plays a central role in the detection and characterization of lung involvement in SSc patients.1, 3, 8, 9, 10, 24, 25 The reported hallmark features5, 26, 27, 28, 29 of SSc-related lung involvement are similar to those of idiopathic NSIP. This association has also been reported5, 6, 30 in radiology-pathology correlations in surgical biopsy specimens. Several studies11, 31, 32, 33, 34, 35 have summarized the results of SSc CT findings (Table 7).
In
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This study was funded by National Institutes of Health (grant UO1 HL 60748) and research grants U01 HL60587-01A1 and R01 HL072424, from the National Heart, Lung, and Blood Institute, Bethesda, MD.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
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A list of SLS participants is given in the Appendix.