RMD Open (Feb 2024)

Characterisation of airway disease associated with Sjögren disease

  • Eric Hachulla,
  • Xavier Mariette,
  • Jacques-Eric Gottenberg,
  • Marie-Pierre Debray,
  • Philippe Dieude,
  • Alain Saraux,
  • Olivier Vittecoq,
  • Emanuelle Dernis,
  • Raphaele Seror,
  • Gaetane Nocturne,
  • Cindy Marques,
  • Veronique Le Guern,
  • Claire Larroche,
  • Robin Dhote,
  • Pierre-Antoine Juge,
  • Anne Laure Fauchais,
  • Antoine Beurnier,
  • Loïc Meudec

DOI
https://doi.org/10.1136/rmdopen-2023-003866
Journal volume & issue
Vol. 10, no. 1

Abstract

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Objective Although airway disease associated with Sjögren’s disease (Sjo-AD) is common, it is poorly studied compared with interstitial lung disease (ILD). In this study, we aimed to assess factors associated with Sjo-AD, the characteristics and prognosis of this manifestation.Methods We performed a retrospective multicentric study involving nine centres. We included Sjo-AD patients confirmed by at least one clinician and one CT scan report. Clinical and biological data, pulmonary function test (PFT), and CT scans were collected. A single radiologist specialist in thoracic diseases reviewed CT scans. Sjo-AD patients were compared with Sjo controls without pulmonary involvement, randomly selected after matching for age and disease duration.Results We included 31 Sjo-AD and 62 Sjo controls without pulmonary history. Sjo-AD had a higher disease activity (ESSDAI) compared with controls, even when excluding the pulmonary domain of the score (7 vs 3.8, p<0.05), mainly due to the biological activity. Sjo-AD was multilobar (72%) and associated with signs of both bronchiectasis and bronchiolitis (60%). Obstructive lung disease occurred in 32% at the time of Sjo-AD diagnosis. Overall, PFT was stable after 8.7±7 years follow-up but repeated CT scans showed extended lesions in 41% of cases within 6±3.2 years. No patient developed Sjo-ILD. Sjo-AD progression was independent of the global disease activity.Conclusions Sjo-AD preferentially affects Sjo patients with higher biological activity. It is often characterised as a diffuse disease, affecting both proximal and distal airways, with a slow evolution over time and no progression to Sjo-ILD.