Pulmonary diseases in SLE: a population-based cross-sectional study

Pulmonary diseases (PDs) in SLE are thought to be common and of clinical importance but can be difficult to diagnose. Prior studies report divergent estimates of the prevalence of PD in SLE ranging from 30% to 98%. Therefore, our primary objective was to determine the prevalence of PD in patients with SLE, through a population-based cross-sectional study. Our secondary objectives were to investigate in patients with SLE: (1) the prevalence of specific subtypes of PD, (2) pulmonary function and (3) associations between selected patient characteristics and presence of PD and subtypes of PD.

We invited adult patients with SLE who met the classification criteria and lived in Region Southern Denmark. Each participant underwent a clinical assessment, pulmonary function tests (PFTs) and a chest high-resolution CT scan (HRCT). Subsequently, participants were assessed and diagnosed according to the presence of PD and subtypes of PD at a multidisciplinary discussion.

We found PDs were prevalent in 109 (59%) of the 185 included participants, among whom interstitial lung diseases were prevalent in 22 (12%), pleural diseases in 35 (19%) and airway diseases in 70 (38%). PD and subtypes of PD were associated with decreased pulmonary function, but the PFT measures showed a low combined sensitivity and specificity for detecting PD and subtypes of PD. We found no strong associations between selected patient characteristics and the presence of PD or subtypes of PD.

59% of patients with SLE have PD, and PD was associated with decreased pulmonary function. Diagnosing PD in SLE remains challenging because clinical assessment and PFTs have limited utility. Accurate diagnosis often requires HRCT or other specialised investigations.

NCT06087523.