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Rheumatology Advance Access published online on May 15, 2009
Rheumatology, doi:10.1093/rheumatology/kep055
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Radiological incomplete thymus involution in systemic sclerosis

Fahrettin Oksel1, Figen Tarhan1, Selen Bayraktaroglu2, Recep Savas2, Figen Yargucu1 and Gökhan Keser1

1Department of Internal Medicine, Division of Rheumatology and 2Department of Radiology, Ege University School of Medicine, Bornova, Izmir, Turkey

Correspondence to: Fahrettin Oksel, Department of Internal medicine, Division of Rheumatology, Ege University School of Medicine, Bornova, Izmir, 35100 Turkey. E-mail: fahrettin.oksel{at}ege.edu.tr


  Abstract

Objective. Thymus plays a crucial role in immune system homeostasis, and thymic abnormalities have been previously reported in many autoimmune diseases, including SSc. The aim of this study is to evaluate the frequency of radiological thymus abnormalities in SSc patients and its relationship with various clinical and laboratory features.

Methods. Sixty-three female SSc patients (diffuse/limited: 49/14), all having pulmonary high-resolution CT (HRCT) scans, taken previously for evaluating lung involvement were included. At the time of the scans, mean age and disease duration of the patients were 50.1 ± 8.5 and 10.2 ± 7.8 years, respectively. As the control group, 45 age-matched female patients, having normal pulmonary HRCT scans taken previously for evaluating non-specific symptoms, were included.

Results. Frequency of incomplete thymus involution was significantly higher in SSc patients (12/63; 19%) compared with the control group (2/45; 4.4%; P = 0.022). In SSc patients with pulmonary fibrosis, incomplete thymus involution was significantly lower (3/38; 7.9%) than those without pulmonary fibrosis (9/25; 36%; P = 0.007).

Conclusion. The present study shows significantly higher frequency of radiological incomplete thymus involution in SSc compared with normal controls. Furthermore, less common occurrence of pulmonary fibrosis in SSc patients with incomplete thymus involution deserves attention. These findings may have some implications regarding the possible role of thymic abnormalities at least in some patients with SSc.

KEY WORDS: Systemic sclerosis, Scleroderma, Thymus, Incomplete thymus involution

Submitted 13 September 2008; Accepted 18 February 2009


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