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. 2015 Jan-Feb;31(1):70-5.
doi: 10.12669/pjms.311.6544.

Pulmonary manifestations of systemic lupus erythematosus patients with and without antiphospholipid syndrome

Muhammad Afzal Hamdani  1 , Abdul Rahman Saud Al-Arfaj  2 , Khalid Parvez  3 , Faisal Naseeb  4 , Abdalla El Fateh Ibrahim  5 , Joseph Hope Cal  6
Affiliations

Pulmonary manifestations of systemic lupus erythematosus patients with and without antiphospholipid syndrome

Muhammad Afzal Hamdani et al. Pak J Med Sci. 2015 Jan-Feb.

Abstract

Objective: To uncover the pulmonary manifestations of Systemic Lupus Erythematosus (SLE) patients alone and to compare findings with antiphospholipid syndrome (APS) associated with SLE.

Methods: This cross sectional comparative study was carried out at King Khalid University Hospital (KKUH)/King Saud University (KSU), a tertiary care hospital, Riyadh, Kingdom of Saudi Arabia. From June 2012 to March 2014, 96 diagnosed SLE patients with respiratory symptoms were included in the study and divided into two groups. Group one included SLE without antiphospholipid syndrome (APS) and group two SLE with APS. We compared Demographic features, clinical manifestations and findings of chest X-Ray, Arterial Blood Gases, Pulmonary function tests, six minute walk test, ventilation perfusion scan, echocardiography and chest high resolution computed tomography.

Results: Demographic and clinical characteristics of two groups were similar. Previous history of deep venous thrombosis (3% vs 27.6%, p=0.001), pulmonary embolism (3% vs34.5%, p<0.0001) and abortions (7.5% vs 27.6%, p=0.019) were significantly more in group two. Levels of Anticardiolipin antibody (0% vs 100%, p<0.0001) and lupus anticoagulant (1.5% vs 79.3%, p<0.0001) were also significantly higher in group two. Hypoxemia measured by pulse oximetry (43.3% vs 65.5% p=0.045, pulmonary Arterial Hypertension (15.5% vs 39.3% p=0.014)), and pulmonary embolism (3.4% vs 21.4% p=0.013) and ventilation perfusion mismatch on V/Q scan (1.5% vs 24.1% p=0.001) were more frequent in group two.

Conclusion: Hypoxemia, pulmonary embolism and pulmonary arterial hypertension were significantly high in SLE patients with APS, requiring long term anticoagulation and treatment and close follow-up.

Keywords: Antiphospholipid Syndrome; Pulmonary manifestations. High resolution computed tomography; Systemic Lupus Erythematosus.

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References

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