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- W4387249513 abstract "SESSION TITLE: Disorders of the Mediastinum Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: The damage of the gastrointestinal tract is one of the main visceral signs of systemic sclerosis (SSc). The most frequently involved area of this tract is the esophagus, affecting 75-90% of patients. The basis pathophysiologic mechanism of esophageal involvement is abnormal esophageal motility and decreased low esophageal sphincter pressure. These disturbance lead to gastroesophageal reflux (GER), esophageal injury, and sometimes, intestinal metaplasia, or Barrett,s esophagus (BE). The purpose of this study was to identify the probable association of esophageal involvement with other clinical manifestations of systemic sclerosis. METHODS: The 52 SSс (50 female, 2 male) patients included in the study have undergone endoscopies of the esophagus to obtain biopsies of the esophagus‘s lining. BE was defined by the finding of intestinal architecture in the lower esophagus displaying a villiform columnar-lined mucosa with goblet cells. The patients were divided in two groups based histological diagnosis: group A (the average age 57.8±9.3 years, SSc duration 11.8±6.0 years, diffused:limited forms 1:6)– with BE, group B (the average age 51.9±10.0 years, SSc duration 7.9±5.2 years, diffused:limited forms 1:2.3) – without BE. All patients had initial standardized evaluation of organ involvement. The patients with dryness in the mouth and/or in the eyes were checked by an ophthalmologist (Shirmer’s test) and by a dentist (sialometria, sialographia and biopsy of small salivary glands). RESULTS: The duration of SSc (from the first non- Raynaud's symptom) was determined to be longer with BE patients (p=0.03). Intestinal metaplasia was more common in the limited form of SSc, than in the diffused (P=0.01). The frequency of dysphagia and pyrosis were about the same in both of the groups. The patients with BE determined to have a higher percentage of insufficiency of cardia (p=0.04) and erosion of the esophagus’s lining (p=0.6). The group A had more frequent dyspnea (p=0,014) and cough (p=0,03), however forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and diffusing capacity for carbon monoxide were not significantly different. The Barrett’s esophagus was determined to correlate with the decrease of FEV1/FVC ratio (R=-0,3). The frequency of other clinical signs of SSc (cardiopathy, pulmonary arterial hypertension, joint syndrome, digital ulcers/necrosis) as well as sings of lab activity were not significantly different in both groups of patients. Patients with BE were more likely to have Sjogren’s syndrome (p=0.02). CONCLUSIONS: The clinical picture of the SSc along with BE did not have distinctive characteristics besides more frequent dyspnea and cough. The patients with BE had Sjogren’s syndrome more frequently, that allows to suppose the secretum quality alteration and volume reduction can play a certain role in progressiveness of esophagus’s pathology along with GER in SSc patients. CLINICAL IMPLICATIONS: Patients with systemic scleroderma and Sjogren's syndrome need regular esophagogastroduodenoscopy due to a higher risk of developing Barrett's esophagus. DISCLOSURES: No relevant relationships by Oxana Desinova No relevant relationships by Liudmila Garzanova No relevant relationships by Olga Koneva No relevant relationships by Olga Ovsyannikova No relevant relationships by Rushana Shayakhmetova No relevant relationships by Mayya Starovoytova" @default.
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- W4387249513 date "2023-10-01" @default.
- W4387249513 modified "2023-10-03" @default.
- W4387249513 title "ASSOCIATION OF ESOPHAGEAL INVOLVEMENT WITH OTHER CLINICAL MANIFESTATIONS OF SYSTEMIC SCLEROSIS" @default.
- W4387249513 doi "https://doi.org/10.1016/j.chest.2023.07.2231" @default.
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