Detection of pulmonary involvement in lupus patients with and without clinical pulmonary symptoms

Abstract

Background: Systemic lupus erythematosus (SLE) involves different body organs including lungs, however, there is limited information on silent pulmonary involvement in systemic lupus, so, the purpose of this study is to identify both occult and manifest pulmonary complication in patients with SLE and its correlation with disease activity parameters, and high resolution computed tomography (HRCT) findings. Method: Fifty female patients fulfilling the ACR criteria for SLE were enrolled and evaluated using chest X-ray, echocardiography (Echo), pulmonary function tests (PFT) and HRCT of the chest to find out the pulmonary involvement. Results: This study was carried out on 50 SLE female patients, 24 (48%) of them were with pulmonary manifestations and 26 (52%) of them were without pulmonary manifestations. HRCT showed abnormalities in 32 patients in contrast to chest X-ray which showed abnormalities only in 22 patients (P-value < 0.05). Mild pulmonary hypertension was found in 4 (8%) patients. Pulmonary function tests indicated that the majority of the patients (80%) presented with restrictive pattern with equal percentage of both symptomatic and asymptomatic patients. Diffusion defect was in 56% of all studied patients. Few patients showed obstructive pattern (4%). Residual volume was high in most of the patients. Conclusion: Pulmonary involvement is present in a significant number of SLE patients as detected by PFTs and HRCT, however, the majority of patients were asymptomatic. Decreased diffusing capacity of females with systemic lupus is prevalent.

Keywords

• Lupus erythematosus
• HRCT
• PFTs
• Diffusing capacity for carbon monoxide in lungs