Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL)

Objectives The objectives of this study were to examine the demographic and clinical features associated with the occurrence of pleuropulmonary manifestations, the predictive factors of their occurrence and their impact on mortality in systemic lupus erythematosus (SLE) patients. Materials and metho...

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Published in:Lupus 2017-11, Vol.26 (13), p.1368-1377
Main Authors: Haye Salinas, M J, Caeiro, F, Saurit, V, Alvarellos, A, Wojdyla, D, Scherbarth, H R, de O e Silva, A C, Tavares Brenol, J C, Lavras Costallat, L T, Neira, O J, Iglesias Gamarra, A, Vásquez, G, Reyes Llerena, G A, Barile-Fabris, L A, Silveira, L H, Sauza del Pozo, M J, Acevedo Vásquez, E M, Alfaro Lozano, J L, Esteva Spinetti, M H, Alarcón, G S, Pons-Estel, B A
Format: Article
Language:English
Subjects:
Adult
Cardiovascular disease
Cohort Studies
Coronary artery disease
Female
Heart diseases
Humans
Ischemia
Kidneys
Lung Diseases - etiology
Lupus
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - mortality
Male
Mortality
Pleurisy
Pleurisy - etiology
Respiratory tract diseases
Respiratory Tract Infections - etiology
Severity of Illness Index
Survival
Systemic lupus erythematosus
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Summary:Objectives The objectives of this study were to examine the demographic and clinical features associated with the occurrence of pleuropulmonary manifestations, the predictive factors of their occurrence and their impact on mortality in systemic lupus erythematosus (SLE) patients. Materials and methods The association of pleuropulmonary manifestations with demographic and clinical features, the predictive factors of their occurrence and their impact on mortality were examined in GLADEL patients by appropriate univariable and multivariable analyses. Results At least one pleuropulmonary manifestation occurred in 421 of the 1480 SLE patients (28.4%), pleurisy being the most frequent (24.0%). Age at SLE onset ≥30 years (OR 1.42; 95% CI 1.10–1.83), the presence of lower respiratory tract infection (OR 3.19; 95% CI 2.05–4.96), non-ischemic heart disease (OR 3.17; 95% CI 2.41–4.18), ischemic heart disease (OR 3.39; 95% CI 2.08–5.54), systemic (OR 2.00; 95% CI 1.37–2.91), ocular (OR 1.58; 95% CI 1.16–2.14) and renal manifestations (OR 1.44; 95% CI 1.09–1.83) were associated with pleuropulmonary manifestations, whereas cutaneous manifestations were negatively associated (OR 0.47; 95% CI 0.29–0.76). Non-ischemic heart disease (HR 2.24; 95% CI 1.63–3.09), SDI scores ≥1 (OR 1.54; 95% CI 1.10–2.17) and anti-La antibody positivity (OR 2.51; 95% CI 1.39–4.57) independently predicted their subsequent occurrence. Cutaneous manifestations were protective of the subsequent occurrence of pleuropulmonary manifestations (HR 0.62; 95% CI 0.43–0.90). Pleuropulmonary manifestations independently contributed a decreased survival (HR: 2.79 95% CI 1.80–4.31). Conclusion Pleuropulmonary manifestations are frequent in SLE, particularly pleuritis. Older age, respiratory tract infection, cardiac, systemic and renal involvement were associated with them, whereas cutaneous manifestations were negatively associated. Cardiac compromise, SDI scores ≥1 and anti-La positivity at disease onset were predictive of their subsequent occurrence, whereas cutaneous manifestations were protective. They independently contributed to a decreased survival in these patients.
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203317699284