TY - THES ID - 134677878 TI - The role of high-resolution manometry in systemic sclerosis: a systematic review AU - Schutyser, Wouter AU - De Langhe, Ellen AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de geneeskunde (Leuven) PY - 2019 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:134677878 AB - Systemic sclerosis (SSc) affects the upper gastro-intestinal (GI) system in up to 90% of patients. This systematic review investigates the role of high-resolution manometry (HRM) in systemic sclerosis, by evaluating correlation between HRM abnormalities and upper gastro-intestinal symptoms or other organ involvement, and reports on effects of therapeutic interventions on HRM findings. A literature search was performed in PubMed and Embase to identify relevant articles using the keywords “HRM” and “systemic sclerosis”. Of 43 articles, 17 met all study selection criteria and were included. The majority of studies assessed correlation between esophageal symptoms and esophageal dysmotility as primary outcome. A limited number of studies assessed the effectiveness of buspirone in SSc patients. Study quality assessment shows that most (11/18) studies were of very good or good quality. Studies that assessed upper GI symptoms using validated questionnaires such as the UCLA SCLC GIT 2.0 or GISSI score found an association between absent contractility on HRM and upper GI symptoms. Asymptomatic patients often have oesophageal body dysmotility when assessed by HRM. Oesophageal body dysmotility on HRM appears positively correlate with presence of interstitial lung disease (ILD) on high-resolution computed tomography (HRCT) while also correlating with DLCO <0.8 of predicted value on pulmonary function testing. There is contradictory evidence on the association between autoantibody profiles and skin involvement with HRM abnormalities. Buspirone appears beneficial as it increases lower oesophageal sphincter (LES) resting pressure and reduces upper GI symptoms. In conclusion, patients describing severe upper GI symptoms using the UCLA SCLC GIT 2.0 or GISSI scores can be expected to have severe oesophageal body dysmotility on HRM. Oesophageal body dysmotility on HRM seems to positively correlate with presence of ILD. Buspirone shows promising benefits as add-on therapy for upper GI symptoms in systemic sclerosis. ER -