Pulmonary Involvement in Systemic Lupus Erythematosus Patients in a Tertiary Care Hospital

In half of the individuals with systemic lupus erythematosus (SLE), over the course of the disease, pulmonary involvement occurs frequently and is one of the parts in the array of presenting symptoms. But the published research and information on SLE have historically concentrated on renal, central nervous system (CNS), and dermatological manifestations, while the pulmonary effects of SLE have received very less attention.

To know the extent and pattern of pulmonary involvement in SLE patients in a tertiary care hospital.

A cross-sectional observational study was conducted among 70 diagnosed SLE [who fulfilled the revised American College of Rheumatology (ACR) criteria for the classification of SLE] patients attending a tertiary care center. Seventy diagnosed SLE patients who met the updated ACR criteria for the classification of SLE and were enrolled in a tertiary care facility in West Bengal participated in a cross-sectional observational study. After informed consent, clinical examinations, general survey, respiratory examination, cardiovascular examination, and relevant investigations [chest X-ray, pulmonary function test, echocardiography and electrocardiography, and high-resolution computed tomography (HRCT)/chest computed tomography (CT) scan] were performed.

The majority of the study subjects belonged to the 21-30 years of age-group (45.7%) and were females. Most of the study subjects were treatment-naïve as they were newly diagnosed. Among the chief presenting complaints, the most common was cough followed by dyspnea and pleuritic chest pain. Chest X-rays showed pleural pathology in 37% of study subjects and pulmonary function tests were found to have a restrictive pattern in 4.3%. Echocardiography documented that 19.6% had pulmonary artery hypertension. HRCT revealed that 19.4% of subjects had definitive findings of interstitial lung diseases (ILD).

A substantial contributor to morbidity and death, SLE is a potentially fatal, commonly debilitating autoimmune illness with pulmonary symptoms. Cough was the most common presenting complaint, and the most common radiological abnormality detected was pleural effusion. Spirometry revealed, as expected, a restrictive pattern in most of the cases. Around 29% of cases revealed features suggestive of or confirmatory evidence for intestinal lung disease. As a whole, the prevalence of lung involvement in SLE in the study was 67%. But this being a study with only 70 participants, a further longitudinal is recommended to study disease activity correlation with the incidence of early pulmonary involvement in SLE disease course.