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Pulmonary manifestations in systemic lupus erythematosus: Association with disease activity
Author(s) -
Alamoudi Omer S.B.,
Attar Suzan M.
Publication year - 2015
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12473
Subject(s) - medicine , interstitial lung disease , dermatology , systemic disease , disease , lupus erythematosus , immunology , lung , antibody
Background and objective Although systemic lupus erythematosus ( SLE ) is the most common connective tissue disease affecting the lung, few studies have assessed risk factors that predict pulmonary manifestations. The objectives of the present study were to determine the prevalence of lung manifestations in SLE patients from W estern S audi A rabia by analysing results from high‐resolution computed tomography ( HRCT ) scans and to identify independent risk factors for lung involvement. Methods This was a 10‐year retrospective study involving 184 SLE patients. We examined all HRCT lung abnormalities and determined whether findings were associated with the presence of lupus nephritis ( LN ), SLE disease activity (as defined by SLE D isease A ctivity I ndex 2000 item scores ≥4 for any and all items) or levels of complement and anti‐double‐stranded DNA (anti‐ds DNA ). Results We identified 61 patients (33%) with pulmonary involvement, and 52 (85%) of these subjects showed HRCT abnormalities. The most common HRCT findings were pleural effusion, consolidation and atelectasis (58%, 42% and 42%, respectively). There was a significant association between abnormal HRCT results and hypocomplementemia, high levels of anti‐ds DNA and disease activity ( P < 0.05), particularly with regard to pleuropericardial effusion and consolidation. Pulmonary abnormalities were significantly higher within the first five years after SLE diagnosis ( P < 0.001). However, neither disease duration nor LN was associated with increased risk. Conclusions Lung manifestations were frequent in SLE patients from S audi A rabia, with pleural effusion, consolidation and atelectasis being the most common. Low complement levels, high anti‐ds DNA levels and disease activity were significantly associated with abnormal HRCT findings (all P < 0.001).