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Respiratory function in systemic lupus erythematosus: relation with activity and severity

G Rolla1, L Brussino, M T Bertero

  • 1Dipartimento di Science Biomediche e Oncologia Umana, University of Torino, Italy.

Lupus
|February 1, 1996
PubMed
Summary

Systemic lupus erythematosus (SLE) patients show reduced respiratory function and increased airway reactivity, even without obvious respiratory symptoms. Treatment improvements in SLE correlate with better lung function, suggesting inflammation impacts airways.

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Area of Science:

  • Pulmonary Medicine
  • Rheumatology
  • Systemic Autoimmune Diseases

Background:

  • Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting multiple organs.
  • Respiratory complications are known in SLE, but subclinical respiratory dysfunction is less understood.
  • Assessing pulmonary function in SLE patients without overt respiratory symptoms is crucial for comprehensive disease management.

Purpose of the Study:

  • To investigate the relationship between respiratory function tests, disease activity, and disease severity in ambulatory SLE patients.
  • To identify specific pulmonary function abnormalities in SLE patients without overt respiratory manifestations.
  • To explore the impact of treatment intensification on respiratory function in SLE.

Main Methods:

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  • Conducted pulmonary function tests (lung volumes, expiratory flows, bronchial reactivity, gas transfer) in 24 SLE outpatients and 24 matched healthy controls.
  • Assessed SLE disease activity using the European Consensus Lupus Activity Measurement (ECLAM) score and disease severity using the Lupus Severity of Disease Index.
  • Measured alveolar-arterial oxygen gradient (AaO2) in SLE patients.

    • Main Results:

    • SLE patients exhibited significantly decreased total lung capacity (TLC), maximal expiratory flow at 25% of vital capacity (MEF25), bronchial threshold to methacholine (PD15FEV1), and transfer factor for carbon monoxide (KCO) compared to controls.
    • 12 out of 24 SLE patients had an abnormally high alveolar-arterial oxygen gradient (AaO2).
    • Higher SLE disease activity (ECLAM score) correlated inversely with KCO, while disease severity correlated with FEV1/VC ratio, MEF50, MEF25, and PD15FEV1.
    • Treatment intensification in eight patients led to significant improvements in KCO and a reduction in ECLAM score.

    Conclusions:

    • Subclinical respiratory dysfunction, including reduced lung volumes and increased airway reactivity, is present in SLE patients even without overt respiratory symptoms.
    • The inverse relationship between disease activity and KCO suggests a link between systemic inflammation and alveolar inflammation.
    • The correlations between disease severity and airway indices indicate cumulative airway damage in SLE.
    • Improvements in respiratory function (KCO) following treatment intensification suggest that pulmonary involvement in SLE is potentially reversible.