OESOPHAGEAL MOTILITY ABNORMALITIES IN SYSTEMIC SCLEROSIS: FREQUENCY AND PREDICTIVE FACTORS

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Published Dec 2, 2009
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Vol. 87 No. 8 (2009): Issue Aug 2009

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Sami Karoui
Meriem Serghini
Mouna Ghouma
Lilia Zouiten
Samira Matri
Imed Ben Ghorbel
Lamia Kallel
Jalel Boubaker
Habib Houmane
Azza Filali

Abstract

Background: Esophageal involvement is frequent during systemic sclerosis. It consists on esophageal motor abnormalities. Esophageal manometry is the gold standard for the diagnosis.
Aim : To determine the frequency and the type of the esophageal motor abnormalities among patients presenting a systemic sclerosis; and to look for factors associated with a greater risk of theses disorders.
Methods: A retrospective study relating to all the esophageal manometries carried out among patients presenting a systemic sclerosis was undertaken.
Results: During a 12 years period, 128 cases were studied. Esophageal motor abnormalities were found among 97 patients (76%). Specific esophageal involvement was found among 52 patients (42%), and non specific motor abnormalities among 31 patients (24%). The only associated factor with a specific esophageal
involvement is occurrence of dysphagia.
Conclusion: Esophageal motor abnormalities are frequent in patients with systemic sclerosis. They can be specific and nonspecific. Esophageal manometry should be systematically performed among these patients, even in the absence of dysphagia.

Keywords:

Esophagus, Systemic sclerosis

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References

  1. Chung L, Lin J, Furst DE, Fiorentino D. Systemic and localized scleroderma. Clin Dermatol. 2006;24:374-92.
  2. Lock G, Holstege A, Lang B, Scholmerich J. Gastrointestinal manifestations of progressive systemic sclerosis. Am J Gastroenterol 1997;92:763-71.
  3. Sallem H, Mcnearney TA, Chen J D Z. Systematic review: Pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma). Aliment Pharmacol Ther 2006; 23:691-712.
  4. Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol 2006;40:769-75.
  5. Johnson SR, Feldman BM, Hawker GA. Classification criteria for systemic sclerosis subsets. J Rheumatol. 2007;34:1855-63.
  6. Karoui S, Boubaker J, Hamzaoui S, Matri S, Fekih M, Filali A. La manométrie oesophagienne : Techniques et indications en pratique courante. Tunis Med 2000; 78 : 622-627.
  7. Furst D, Khanna D, Matucci-Cerinic M, Clements P, Steen V, Pope J, Merkel P, Foeldvari I, Seibold J, Pittrow D, Polisson R, Strand V. Systemic sclerosis - continuing progress in developing clinical measures of response. J Rheumatol 2007;34:1194-200.
  8. Marie I. Gastrointestinal involvement in systemic sclerosis. Presse Med. 2006;35(12 Pt 2):1952-65
  9. Ling TC, Johnston BT. Esophageal investigations in connective tissue disease: which tests are most appropriate? J Clin Gastroenterol. 2001;32:33-6.
  10. Zamost BJ, Hirschberg J, Ippoloti AF, Furst DE, Clements PJ, Weinstein WN. Esophagitis in scleroderma . Prevalence and risk factors. Gastroenterology 1987;92:412-8.
  11. Abu-Shakra M, Guillemin F, Lee P. Gastro-intestinal manifestations of systemic sclerosis. Semin Arthritis Rheum 1994;24:29-39.
  12. Correia l, Palma R, Ferreira P, Pires E, Lopes J, Carvalhinhos A. Esophageal manometry in progressive systemic sclerosis. Gut 1996;39 (suppl 3):A198.
  13. Henry MA, Harbermann MC, Rocha OM. Esophageal motor disturbances in progressive systemic sclerosis. Dis Esophagus. 1999;12:51-3.
  14. Szamosi S, Szekanecz Z, Szucs G. Gastrointestinal manifestations in Hungarian scleroderma patients. Rheumatol Int. 2006;26:1120-4.
  15. Airò P, Della Casa D, Danieli E, Missale G, Cattaneo R, Cestari R. Oesophageal manometry in early and definite systemic sclerosis. Clin Rheumatol. 2005;24:370-6
  16. Wegener M, Adamek RJ, Wedmann B , Jergas M, Altmeyer P . Gastrointestinal transit through esophagus, stomach, small and large intestine in patients with progressive systemic sclerosis. Dig Dis Sci 1994;39:2209-15.
  17. Weston S, Thumshirn M, Camilleri M. Clinical and upper gastrointestinal motility in systemic sclerosis and related disorders. Am J Gastroenterol 1998 ;93:1085-9.
  18. Lock G, Zeuner M, Straub RH, Hein R, Lang B, Scholmerich J et al. Esophageal manometry in systemic sclerosis: screening procedure or confined to symptomatic patients ? Rheumatol Int 1997;17:61-6.
  19. Johnson DA, Drane WE, Curran T, Catau EL, Ciarleglio, Khan A et al. Pulmonary disease in progressive systemic sclerosis . A complication of gastrooesophageal reflux and occult aspiration? Arch Intern Med 1989 ;149:589-593.
  20. Lock G, Pfeifer M, Straub RH, Zeuner M, Lang B, Scholmerich J, Holstege A. Association of esophageal dysfunction and pulmonary function impairment in systemic sclerosis. Am J Gastroenterol 1998;93:341-5.
  21. Troshinsky MB, Kane GC, Vargas J et al. Pulmonary function and gastroesophageal reflux in systemic sclerosis. Ann Intern Med 1994;121:6-10.
  22. Bassoti G, Battaglia E, Debernadi V, Germani U, Quiriconi F, Dughera L et al. Esophageal dysfunction in scleroderma : relationship with disease subsets. Arthritis Rheum . 1997;40:2252-9.
  23. Villadsen GE, Storkholm J, Zachariae H, Hendel L, Bendtsen F, Gregersen H. Oesophageal pressure-cross-sectional area distributions and secondary peristalsis in relation to subclassification of systemic sclerosis. Neurogastroenterol Motil 2001; 13: 199-210.
  24. Gonzalez R, Storr M, Bloching H, Seige M, Ott R, Allescher HD. Auto-antibody profile in progressive systemic sclerosis as marker of oesophageal involvement. J Clin Gastroenterol 2001; 32: 123- 127.
  25. Cozzi F, Zucchetta P, Durigon N, Marzola MC, Bullo A, Favaro M, Bui F, Todesco S. Changes in esophageal peristalsis in diverse clinical forms and antibody specificity in scleroderma: a scintigraphic study in 100 cases. Reumatismo. 2003; 55 : 86-92.