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Do patients with systemic sclerosis have abnormal gallbladder function?
W F Posthuma1, M Ledeboer, A A Masclee
1Department of Gastroenterology, University Hospital Leiden, The Netherlands.
Objective:
To determine gallbladder motility in patients with systemic sclerosis.
Design:
Case control study.
Setting:
University hospital, out-patient department of rheumatology.
Patients:
Ten patients with systemic sclerosis according to the criteria of the American Rheumatism Association with documented involvement of the gastrointestinal tract and 10 healthy controls matched for age, sex and body mass index.
Intervention:
Cephalic vagal cholinergic simulation by modified sham feeding and hormonal stimulation by infusion of cholecystokinin.
Measurements:
Gallbladder volume obtained by ultrasonography and determination of plasma cholecystokinin concentrations.
Results:
Fasting gallbladder volumes were not significantly different between patients with systemic sclerosis and controls (19.6 +/- 1.9 cm3 and 23.3 +/- 2.9 cm3, respectively, mean plus or minus standard error of the mean). Neither were there significant differences in reduction of gallbladder volume in response to modified sham feeding (35 +/- 4% and 33 +/- 4%, respectively) nor during cholecystokinin infusion (56 +/- 4% and 60 +/- 6%, respectively). The increase in plasma cholecystokinin levels during infusion was not different in the two groups.
Conclusion:
Gallbladder motility in patients with systemic sclerosis is preserved in response to both cholinergic and hormonal stimulation, even when other gastrointestinal motor disturbances are present. These results suggest that patients with systemic sclerosis are not at increased risk for cholelithiasis because of gallbladder dysmotility.