Chest imaging manifestations in lupus nephritis

Area of Science:

• Nephrology
• Radiology
• Pulmonology

Background:

• Systemic lupus erythematosus (SLE) can affect multiple organs, including the kidneys and lungs.
• Lupus nephritis (LN) is a severe manifestation of SLE, and understanding its systemic impact is crucial.
• Chest imaging findings in LN patients require further investigation to correlate with renal pathology.

Purpose of the Study:

• To analyze the association between renal histopathological features and chest computed tomography (CT) findings in lupus nephritis (LN) patients.
• To compare the incidence of lung and pleural diseases in LN patients versus SLE patients without LN.

Main Methods:

• Retrospective review of medical records and chest CT scans from 152 LN patients and 93 SLE patients without LN.
• Evaluation of 64-detector row CT images by a thoracic radiologist blinded to clinical information.
• Correlation analysis between renal biopsy findings and CT imaging features.

Main Results:

• LN patients exhibited a significantly higher incidence of lung/pleural disease (61.8% vs. 44.0%).
• Common CT findings in LN included ground glass opacity, interlobular septal thickening, reticular opacities, pleural effusions, and consolidation.
• Renal hyaline thrombi were independently associated with ground glass opacity on CT scans (p=0.042).
• Specific LN classes correlated with distinct CT findings: Class I (traction bronchiectasis), Class III (ground glass opacity), and Class IV (pleural effusions).
• Pleural effusions were associated with cellular/fibrous crescents and interstitial lesions/inflammation/fibrosis.

Conclusions:

• Lupus nephritis patients are more prone to developing lung and pleural diseases.
• Chest CT findings, such as ground glass opacity, can be associated with specific renal histopathological features like hyaline thrombi.
• CT imaging may offer insights into the systemic manifestations of lupus nephritis.