Brief Report: Pulmonary Function Tests: High Rate of False‐Negative Results in the Early Detection and Screening of Scleroderma‐Related Interstitial Lung Disease

• Published in: Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2015-12, Vol.67 (12), p.3256-3261
• Main Authors: Suliman, Yossra A., Dobrota, Rucsandra, Huscher, Dörte, Nguyen‐Kim, Thi D. L., Maurer, Britta, Jordan, Suzana, Speich, Rudolf, Frauenfelder, Thomas, Distler, Oliver
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Antinuclear; Cohort Studies; Diagnostic Errors; Early Diagnosis; False Negative Reactions; Female; Humans; Logistic Models; Lung diseases; Lung Diseases, Interstitial - diagnosis; Lung Diseases, Interstitial - diagnostic imaging; Lung Diseases, Interstitial - etiology; Lung Diseases, Interstitial - immunology; Male; Middle Aged; Multidetector Computed Tomography; Performance evaluation; Prospective Studies; Pulmonary Diffusing Capacity; Pulmonary Fibrosis - diagnosis; Pulmonary Fibrosis - diagnostic imaging; Pulmonary Fibrosis - etiology; Pulmonary Fibrosis - immunology; Respiratory Function Tests; Scleroderma; Scleroderma, Systemic - complications; Scleroderma, Systemic - diagnosis; Scleroderma, Systemic - diagnostic imaging; Scleroderma, Systemic - immunology; Total Lung Capacity; Vital Capacity
• ISSN: 2326-5191; 2326-5205
• DOI: 10.1002/art.39405

Objective Validated methods for the screening and early diagnosis of systemic sclerosis (SSc; scleroderma)–related interstitial lung disease (ILD) are needed. The aim of this study was to evaluate the performance of pulmonary function tests (PFTs) compared with that of high‐resolution computed tomography (HRCT) of the chest for the detection of SSc‐related ILD in clinical practice, and to identify predictors of lung involvement that is functionally occult but significant on HRCT. Methods Prospectively enrolled patients with SSc were assessed according to the European League Against Rheumatism (EULAR)/EULAR Scleroderma Trial and Research standards. The assessment included PFTs and HRCT. The HRCT images were evaluated in a blinded manner by 2 experienced radiologists. The performance parameters of PFTs for the diagnosis of SSc‐related ILD were calculated. Predictors of significant ILD as determined by HRCT in patients with normal forced vital capacity (FVC) values were identified through logistic regression. Results Among the 102 patients, 64 (63.0%) showed significant ILD on HRCT, while only 27 (26.0%) had an FVC