Tuesday, 18 Feb 2020

You are here

High False Negative Rate with PFTs in Scleroderma

Researchers in Zurich studed 102 systemic sclerosis with serial PFTs and high-resolution computed tomography of the chest (HRCT). They found significant interstitial lung disease (ILD) by HRCT in 63 percent. But, only 26 percent had a forced vital capacity (FVC) <80 percent, and 53 percent had a reduction in one or more PFTs.

The false negative rate of FVC was high, with normal FVC in 62.5 percent of patients despite evidence of significant ILD on HRCT. Six percent of patients with normal FVC had severe, functionally-occult lung fibrosis; two of these patients had all PFTs within normal limits.

Compared with ILD-free cases, false negative cases more often had anti-Scl-70 antibodies and diffuse SSc, and less frequently had anti-centromere antibodies (ACAs).

There may be a high risk of missing significant SSc-ILD if relying solely on PFTs. The authors call for more comprehensive screening algorithms for early and accurate detection of ILD.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

BSR Guidelines for Giant Cell Arteritis

NICE has commissioned an update to the 2010 British Society for Rheumatology guideline for the management of giant cell arteritis, and proposed a total of 19 recommendations for the diagnosis and treatment of GCA.

PEXIVAS - Plasma Exhange Fails to Boost Outcomes in Severe AAV

The PEXIVAS study showed that plasma exchange did not reduce the incidence of death or ESKD in patients with severe ANCA–associated vasculitis.

Shingles Vaccine Lowers Risk of CVA

Shingles infection has been historically linked to an increased risk of stroke. A new study found that Zoster Vaccine Live, one type of shingles vaccination, may prevent stroke in some older adults.

EULAR Recommendations on Sjögren’s Syndrome

The European League Against Rheumatism (EULAR) has established an international collaborative group (EULAR SS Task Force) to develop the first EULAR evidence and consensus-based recommendations for the management of patients with Sjogens syndrome (SjS).

Steroid-Sparing Effect of Tocilizumab in Refractory Takayasu Arteritis

A controlled clinical trial has shown that giving the IL-6 receptor antibody, tocilizumab (TCZ), to  patients with Takayasu arteritis (TAK) results in clinical efficacy and has a steroid sparing efffect.