Introduction: Systemic lupus erythematosus (SLE) is the autoimmune disease with the highest prevalence of pulmonary involvement, which ranges from 20% to 90% of the patients, depending on the criteria employed in the cohorts being studied (symptomatology or histopathology). More than 50% of the patients develop pleuropulmonary manifestations at least once during the course of the disease; likewise, pleuropulmonary involvement has been associated with a higher rate of mortality. The purpose of this study is to determine the frequency of respiratory symptoms, and abnormal lung function in a sample of Brazilian patients with systemic lupus erythematosus (SLE). Methods: Retrospective study of 55 SLE patients from a single Rheumatology Unit in Brazil; the patients fulfilling the ACR criteria for SLE. Demographics and clinical characteristics were recorded and the patients were evaluated using chest X-rays, pulmonary function tests (PFTs), and HRCT of the chest to find out the pulmonary involvement. Results: Thirty-two patients had respiratory symptoms, 45 (82%) patients had abnormal lung function, 25 (45.4%) patients had abnormal computed tomography and 20 (36.4%) patients had abnormal chest X-ray. Conclusion: Respiratory symptoms and abnormal lung function are common in SLE. Clinicians should consider pulmonary evaluation among patients with systemic lupus erythematosus with and without respiratory symptoms.
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Almeida, M. D. S. T. M. , Pires, C. F. and Almeida, J. V. M. (2022). Lung in Systemic Lupus Erythematosus: A Single-Center Experience. Open Access Library Journal, 9, e9248. doi: http://dx.doi.org/10.4236/oalib.1109248.
Pisetsky, D.S., Gilkeson, G. and St Clair, E.W. (1997) Systemic Lupus Erythematosus. Diagnosis and Treatment. Medical Clinics of North America, 81, 113-128.
https://doi.org/10.1016/S0025-7125(05)70507-1
Kamen, D.L. and Strange, C. (2010) Pulmonary Manifestations of Systemic Lupus Erythematosus. Clinics in Chest Medicine, 31, 479-488.
https://doi.org/10.1016/j.ccm.2010.05.001
Alarcon, G.S., Friedman, A.W., Straaton, K.V., et al. (1999) Systemic Lupus Erythematosus in Three Ethnic Groups: III. A Comparison of Characteristics Early in the Natural History of the LUMINA Cohort. Lupus, 8, 197-209.
https://doi.org/10.1191/096120399678847704
Pego-Reigosa, J.M., Medeiros, D.A. and Isenberg, D.A. (2009) Respiratory Manifestations of Systemic Lupus Erythematosus: Old and New Concepts. Best Practice & Research Clinical Rheumatology, 23, 469-480.
https://doi.org/10.1016/j.berh.2009.01.002
Hellman, D.B., Kirsch, C.M., Whiting-O’Keefe, Q., Simonson, J., Schiller, N.B., Petri, M., et al. (1995) Dyspnea in Ambulatory Patients with SLE: Prevalence, Severity, and Correlation with Incremental Exercise Testing. The Journal of Rheumatology, 22, 455-461.
Fenlon, H.M., Doran, M., Sant, S.M. and Breatnach, E. (1996) High-Resolution Chest CT in Systemic Lupus Erythematosus. American Journal of Roentgenology, 166, 301-307. https://doi.org/10.2214/ajr.166.2.8553934
Kakati, S., Doley, B., Dihingia, P., Pegu, U., Pal, S. and Deka, U.J. (2008) A Clinical Study of Pulmonary Manifestations in Systemic Lupus Erythematosus with Special Reference to CT Findings. Indian Journal of Rheumatology, 2, 133-136.
https://doi.org/10.1016/S0973-3698(10)60056-8
Cuchacovich, R. and Gedalia, A. (2009) Pathophysiology and Clinical Spectrum of Infections in Systemic Lupus Erythematosus. Rheumatic Diseases Clinics of North America, 35, 75-93. https://doi.org/10.1016/j.rdc.2009.03.003
MINISTéRIO DA SAúDE, Secretaria de Atenção à Saude. (2016) Portaria n° 761 de 21 de junho de 2016.
https://bvsms.saude.gov.br/bvs/saudelegis/sas/2016/prt0761_21_06_2016.html
Pereira, C.A.C., Carvalho, C.R.R. and Nakatani, J. (1996) I Consenso Brasileiro Sobre Espirometria. Jornal Brasileiro de Pneumologia e Tisiologia, 22, 106-164.
Sante, L.R. and Wyatt, J.P. (1951) Roentgenological and Pathological Observations in Antigenic Pneumonitis, Its Relationship to the Collagen Diseases. The American Journal of Roentgenology and Radium Therapy, 66, 527-545.
Rakov, H. and Taylor, J. (1942) Acute Disseminated Lupus Erythematosus: Without Cutaneous Manifestations and with Heretofore Undescribed Pulmonary Lesions. Archives of Internal Medicine, 70, 88-100.
https://doi.org/10.1001/archinte.1942.00200190098006
Tselios, K. and Urowitz, M.B. (2017) Cardiovascular and Pulmonary Manifestations of Systemic Lupus Erythematosus. Current Rheumatology Reviews, 13, 206-218.
https://doi.org/10.2174/1573397113666170704102444
Hannah, J.R. and D’Cruz, D.P. (2019) Pulmonary Complications of Systemic Lupus Erythematosus. Seminars in Respiratory and Critical Care Medicine, 40, 227-234.
https://doi.org/10.1055/s-0039-1685537
Fidler, L., Keen, K.J., Touma, Z. and Mittoo, S. (2016) Impact of Pulmonary Disease on Patient-Reported Outcomes and Patient-Performed Functional Testing in Systemic Lupus Erythematosus. Lupus, 25, 1004-1011.
https://doi.org/10.1177/0961203316630818
Silberstein, S.L., Barland, P., Grayzel, A.I. and Koerner, S.K. (1980) Pulmonary Dysfunction in Systemic Lupus Erythematosus: Prevalence, Classification and Correlation with Other Organ Involvement. The Journal of Rheumatology, 7, 187-195.
Grennan, D.M., Howie, A.D., Moran, F. and Buchanan, W.W. (1978) Pulmonary Involvement in Systemic Lupus Erythematosus. Annals of the Rheumatic Diseases, 37, 536-539. https://doi.org/10.1136/ard.37.6.536
Fernandez, M., Alarcon, G.S., Calvo-Alén, J., et al. (2007) A Multiethnic, Multicenter Cohort of Patients with Systemic Lupus Erythematosus (SLE) as a Model for the Study of Ethnic Disparities in SLE. Arthritis & Rheumatism (Arthritis Care & Research), 57, 576-584. https://doi.org/10.1002/art.22672