Tohoku J. Exp. Med., 2015 December, 237(4)

Computed Tomography of the Esophagus in Scleroderma and Lung Disease

DAISUKE TAKEKOSHI,¹ SHIVA ARAMI,² TODD J. SHEPPARD,¹ PATRICIA COLE-SAFFOLD,¹ JON C. MICHEL,¹ GEORGE T. KONDOS³ and DEAN E. SCHRAUFNAGEL¹

¹Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
²Division of Rheumatology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
³Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA

Systemic sclerosis, or scleroderma, is a collagen vascular disease characterized by hardening of the skin and involvement of internal organs, most commonly the esophagus. The most frequent cause of death in these patients is lung disease. Esophageal dysfunction has been implicated in the pathogenesis of interstitial lung disease. We previously developed a standard for the esophageal diameter on chest computed tomography (CT) and hypothesized that patients with esophageal dilation would be more likely to have interstitial lung disease than those without. In this study, we test this in 121 systemic sclerosis patients with interstitial lung disease and 48 of those without interstitial lung disease. For controls, we evaluated 121 patients followed at a general pulmonary clinic and the previously studied normal healthy standards. This study demonstrated that esophageal dilation is common in systemic sclerosis patients (66.3% for the maximal esophageal diameter more than or equal to 15 mm), that systemic sclerosis patients with interstitial lung disease have more dilated esophagi than those without interstitial lung disease (median 19.4 mm vs. 14.1 mm), and that esophageal parameters are negatively correlated with pulmonary function. We also found that patients from general pulmonary clinic were more likely to have dilated esophagi than normal controls (median 12.1 mm vs. 9.7 mm). The CT measurement of esophageal diameter may be a useful marker of patients at risk for developing lung disease.

keywords —— computed tomography; esophageal dilation; interstitial lung disease; reflux disease; systemic sclerosis

© 2015 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2015, 237, 345-352

Correspondence: Dean E. Schraufnagel, M.D., Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, M/C 719, 840 South Wood St., Chicago, IL 60612-7323, USA.

e-mail: schrauf@uic.edu