{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:17:36Z","timestamp":1787026656882,"version":"build-2736575974"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung involvement in primary Sj\u00f6gren\u2019s syndrome (pSS) may vary from 9 to 90%. Interstitial lung disease and tracheobronchial alterations are the most typical findings. The evidence of primarily emphysematous changes at computed tomography of the chest of pSS patients has occasionally been described but poorly characterized. This study aims to assess pulmonary involvement and the impact on respiratory function in a cohort of pSS patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 22 consecutive patients diagnosed with pSS underwent pulmonary function tests to investigate the presence of ventilatory impairment and evaluate the exchanges of alveolar gases. All patients underwent a chest high-resolution computed tomography (HRTC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Dynamic volumes were within the normal range in 21 patients (95.4%). A reduction in the diffusing capacity of the lung for carbon monoxide (DLCO) was observed in 18 patients (81.8%). Ten (45.5%) patients showed a mild degree deficit, while 8 patients (36%) showed a moderate degree deficit. Analysis of DLCO revealed a significant difference between pSS patients and controls [\n                      <jats:italic>t<\/jats:italic>\n                      (30.98) = \u221210.77;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001], showing a higher DLCO value for the healthy controls (mean \u00b1 SE; 101.27 \u00b1 6.08) compared to pSS patients (mean \u00b1 SE; 65.95 \u00b1 12.78). Emphysema was found in 21 (94.5%) patients and was the most widespread pulmonary injury. Tracheal thickness was reduced in 15 (67%) patients. Micronodules were observed in 10 (45%) patients in all the pulmonary fields. Bronchial wall thickening and bronchiectasis were observed in 8 (36%) patients, mainly in the lower lobes. Ground glass was found in 5 (22.5%) patients in lower and higher lobes. Cysts were observed in two patients (9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The reduction of the DLCO could be related to early emphysematous alterations in the absence of spirometric alterations and relevant respiratory symptoms. In conclusion, emphysema might be seen as an early pulmonary involvement mark in patients suffering from pSS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2022.998028","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T01:37:35Z","timestamp":1666921055000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Radiological patterns and pulmonary function values of lung involvement in primary Sj\u00f6gren\u2019s syndrome: A pilot analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Ilaria","family":"Mormile","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Mormile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Wanda","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tullio","family":"Valente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Candia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francescopaolo","family":"Granata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Rega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Orlandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Matucci-Cerinic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Molino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amato","family":"de Paulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"438","DOI":"10.12968\/hmed.2017.78.8.438","article-title":"Sjogren\u2019s syndrome.","volume":"78","author":"Thorne","year":"2017","journal-title":"Br J Hosp Med (Lond)."},{"key":"B2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s00393-009-0518-3","article-title":"[Epidemiology of primary Sjorgren\u2019s syndrome].","volume":"69","author":"Westhoff","year":"2010","journal-title":"Z Rheumatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"277","DOI":"10.5114\/reum.2019.89520","article-title":"Classification criteria for secondary Sjogren\u2019s syndrome. Current state of knowledge.","volume":"57","author":"Sebastian","year":"2019","journal-title":"Reumatologia."},{"key":"B4","doi-asserted-by":"publisher","first-page":"354","DOI":"10.3238\/arztebl.2017.0354","article-title":"The diagnosis and treatment of Sjogren\u2019s syndrome.","volume":"114","author":"Stefanski","year":"2017","journal-title":"Dtsch Arztebl Int."},{"key":"B5","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s00393-006-0101-0","article-title":"[Sjogren\u2019s syndrome. Current aspects from a rheumatological point of view].","volume":"65","author":"Tomiak","year":"2006","journal-title":"Z Rheumatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s10067-005-0059-3","article-title":"Circulating Auto-antibodies against nuclear and non-nuclear antigens in primary Sjogren\u2019s syndrome: prevalence and clinical significance in 335 patients.","volume":"25","author":"Nardi","year":"2006","journal-title":"Clin Rheumatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"247","DOI":"10.2147\/CLEP.S47399","article-title":"The epidemiology of Sjogren\u2019s syndrome.","volume":"6","author":"Patel","year":"2014","journal-title":"Clin Epidemiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1183\/16000617.0011-2016","article-title":"Pulmonary manifestations of Sjogren\u2019s syndrome.","volume":"25","author":"Flament","year":"2016","journal-title":"Eur Respir Rev."},{"key":"B9","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1055\/s-0034-1371529","article-title":"Pulmonary involvement in Sjogren syndrome.","volume":"35","author":"Kreider","year":"2014","journal-title":"Semin Respir Crit Care Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.ejrad.2004.01.006","article-title":"High-resolution CT imaging of the lung for patients with primary Sjogren\u2019s syndrome.","volume":"52","author":"Lohrmann","year":"2004","journal-title":"Eur J Radiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"464","DOI":"10.3899\/jrheum.140370","article-title":"Chronic obstructive pulmonary disease is common in never-smoking patients with primary Sjogren syndrome.","volume":"42","author":"Nilsson","year":"2015","journal-title":"J Rheumatol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1007\/s00296-009-1152-8","article-title":"Lung involvement in patients with primary Sjogren\u2019s syndrome: What are the predictors?","volume":"30","author":"Yazisiz","year":"2010","journal-title":"Rheumatol Int."},{"key":"B13","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1080\/03009740410006196","article-title":"Long-term follow-up study of pulmonary findings in patients with primary Sjogren\u2019s syndrome.","volume":"33","author":"Pertovaara","year":"2004","journal-title":"Scand J Rheumatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1378\/chest.70.3.354","article-title":"Pulmonary manifestations of Sjogren\u2019s syndrome.","volume":"70","author":"Strimlan","year":"1976","journal-title":"Chest."},{"key":"B15","first-page":"831","article-title":"Pleuropulmonary abnormalities in primary Sjogren\u2019s syndrome.","volume":"20","author":"Gardiner","year":"1993","journal-title":"J Rheumatol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/RTI.0b013e3181c1acec","article-title":"Lung disease related to collagen vascular disease.","volume":"24","author":"Lynch","year":"2009","journal-title":"J Thorac Imaging."},{"key":"B17","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1002\/art.30077","article-title":"Combined pulmonary fibrosis and emphysema syndrome in connective tissue disease.","volume":"63","author":"Cottin","year":"2011","journal-title":"Arthritis Rheum."},{"key":"B18","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s12288-018-1016-z","article-title":"Langerhans histiocytosis renders a differential and complementary diagnosis for a Sjogren syndrome female presenting with a hypophyseal mass, pulmonary emphysema and thyroid nodules.","volume":"35","author":"Li","year":"2019","journal-title":"Indian J Hematol Blood Transfus."},{"key":"B19","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1111\/eos.12536","article-title":"Current concepts on Sjogren\u2019s syndrome - classification criteria and biomarkers.","volume":"126","author":"Jonsson","year":"2018","journal-title":"Eur J Oral Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.rbr.2015.06.004","article-title":"Validation and psychometric properties of the eular Sjogren\u2019s syndrome patient reported index (ESSPRI) into Brazilian Portuguese.","volume":"55","author":"Paganotti","year":"2015","journal-title":"Rev Bras Reumatol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1136\/ard.2010.143743","article-title":"Eular Sjogren\u2019s syndrome patient reported index (ESSPRI): development of a consensus patient index for primary Sjogren\u2019s syndrome.","volume":"70","author":"Seror","year":"2011","journal-title":"Ann Rheum Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.jaut.2013.12.010","article-title":"Outcome measures for primary Sjogren\u2019s syndrome: a comprehensive review.","volume":"51","author":"Seror","year":"2014","journal-title":"J Autoimmun."},{"key":"B23","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s12016-009-8128-z","article-title":"Spirometry.","volume":"37","author":"Liou","year":"2009","journal-title":"Clin Rev Allergy Immunol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1164\/rccm.200403-417OC","article-title":"Pulmonary manifestations of primary Sjogren\u2019s syndrome: a clinical, radiologic, and pathologic study.","volume":"171","author":"Ito","year":"2005","journal-title":"Am J Respir Crit Care Med."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00016-2016","article-title":"2017 ERS\/ATS standards for single-breath carbon monoxide uptake in the lung.","volume":"49","author":"Graham","year":"2017","journal-title":"Eur Respir J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement.","volume":"200","author":"Graham","year":"2019","journal-title":"Am J Respir Crit Care Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1164\/rccm.201710-1981ST","article-title":"Recommendations for a standardized pulmonary function report. An official American thoracic society technical statement.","volume":"196","author":"Culver","year":"2017","journal-title":"Am J Respir Crit Care Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","article-title":"ATS statement: guidelines for the six-minute walk test.","volume":"166","year":"2002","journal-title":"Am J Respir Crit Care Med."},{"key":"B29","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion.","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc."},{"key":"B30","doi-asserted-by":"publisher","first-page":"W248","DOI":"10.2214\/AJR.09.2672","article-title":"Slope of emphysema index: an objective descriptor of regional heterogeneity of emphysema and an independent determinant of pulmonary function.","volume":"194","author":"Chae","year":"2010","journal-title":"AJR Am J Roentgenol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1056\/NEJMoa11798","article-title":"Patients at high risk of death after lung-volume-reduction surgery.","volume":"345","author":"National Emphysema Treatment Trial Research Group, Fishman","year":"2001","journal-title":"N Engl J Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1148\/radiol.2462070712","article-title":"Fleischner society: glossary of terms for thoracic imaging.","volume":"246","author":"Hansell","year":"2008","journal-title":"Radiology."},{"key":"B33","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1164\/ajrccm.152.2.7633722","article-title":"Comparison of computed density and macroscopic morphometry in pulmonary emphysema.","volume":"152","author":"Gevenois","year":"1995","journal-title":"Am J Respir Crit Care Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1148\/rg.301095110","article-title":"Quantitative CT assessment of chronic obstructive pulmonary disease.","volume":"30","author":"Matsuoka","year":"2010","journal-title":"Radiographics."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1269","article-title":"Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials.","volume":"350","author":"Conway","year":"2015","journal-title":"BMJ."},{"key":"B36","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1093\/rheumatology\/ker409","article-title":"Frequent development of chronic obstructive pulmonary disease in primary SS\u2013results of a longitudinal follow-up.","volume":"51","author":"Mandl","year":"2012","journal-title":"Rheumatology (Oxford)."},{"key":"B37","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1093\/rheumatology\/kes311","article-title":"Clinical pulmonary involvement in primary Sjogren\u2019s syndrome: prevalence, quality of life and mortality\u2013a retrospective study based on registry data.","volume":"52","author":"Palm","year":"2013","journal-title":"Rheumatology (Oxford)."},{"key":"B38","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1136\/ard.58.1.61","article-title":"Lung involvement in primary Sjogren\u2019s syndrome is mainly related to the small airway disease.","volume":"58","author":"Papiris","year":"1999","journal-title":"Ann Rheum Dis."},{"key":"B39","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1136\/thx.36.4.286","article-title":"Pulmonary function abnormalities in Sjogren\u2019s syndrome and the sicca complex.","volume":"36","author":"Segal","year":"1981","journal-title":"Thorax."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1007\/s00277-019-03641-x","article-title":"Pulmonary function abnormalities are common in patients with multiple myeloma and are independently associated with worse outcome.","volume":"98","author":"Trakada","year":"2019","journal-title":"Ann Hematol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.2214\/ajr.161.6.8249719","article-title":"Serial CT in fibrosing alveolitis: prognostic significance of the initial pattern.","volume":"161","author":"Wells","year":"1993","journal-title":"AJR Am J Roentgenol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1159\/000335473","article-title":"Detection of interstitial lung disease in systemic sclerosis through partitioning of lung transfer for carbon monoxide.","volume":"84","author":"Pernot","year":"2012","journal-title":"Respiration."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00332","article-title":"Lung involvement in primary Sjogren\u2019s syndrome-an under-diagnosed entity.","volume":"7","author":"Sogkas","year":"2020","journal-title":"Front Med (Lausanne)."},{"key":"B44","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1164\/rccm.201411-2094CI","article-title":"Diffuse cystic lung disease. Part I.","volume":"191","author":"Gupta","year":"2015","journal-title":"Am J Respir Crit Care Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s13244-010-0050-7","article-title":"A practical approach to cystic lung disease on HRCT.","volume":"2","author":"Beddy","year":"2011","journal-title":"Insights Imaging."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3502438","article-title":"Pathologic and radiologic correlation of adult cystic lung disease: a comprehensive review.","volume":"2017","author":"Boddu","year":"2017","journal-title":"Patholog Res Int."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.998028\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T01:37:38Z","timestamp":1666921058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.998028\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,28]]},"references-count":46,"alternative-id":["10.3389\/fmed.2022.998028"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.998028","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,28]]},"article-number":"998028"}}