The lung is frequently involved in patients with progressive systemic sclerosis (PSS). Risk factors for the development of interstitial lung disease (ILD) include diffuse skin involvement (proximal to the MCPs), and the presence of anti-Scl-70 anti-topoisomerase antibodies. The risk of developing ILD is greatest early in the course of PSS. Even in patients with fibrosis on chest CT, PFTs can be normal. DLCO may be reduced as a result of pulmonary hypertension and not ILD. Therefore, many experts recommend a chest CT in patients with PSS especially with diffuse disease and with anti-Scl antibodies.¹ A review of PSS patients with anti-Scl antibodies showed that 72% to 78.4% had a chest CT between 2016 and 2020.
¹Cottin V, Brown KK. Respiratory Research 2019;20:13.