Analysis of systemic lupus erythematosus-related interstitial pneumonia: a retrospective multicentre study.
Noriyuki EnomotoRyoko EgashiraKazuhiro TabataMikiko HashisakoMasashi KitaniYuko WasedaTamotsu IshizukaSatoshi WatanabeKazuo KasaharaShinyu IzumiAkira ShirakiAtsushi MiyamotoKazuma KishiTomoo KishabaChikatosi SugimotoYoshikazu InoueKensuke KataokaYasuhiro KondohYutaka TsuchiyaTomohisa BabaHiroaki SugiuraTomonori TanakaHiromitsu SumikawaTakafumi SudaPublished in: Scientific reports (2019)
Thoracic diseases in patients with systemic lupus erythematosus (SLE), especially interstitial pneumonia (SLE-IP), are rare and have been poorly studied. The aims of this multicentre study were to evaluate SLE-IP and elucidate its clinical characteristics and prognosis. Fifty-five patients with SLE-IP who had attended the respiratory departments of participating hospitals were retrospectively evaluated in this multicentre study. Clinical information, high-resolution computed tomography (HRCT), and surgical lung biopsy/autopsy specimens were analysed by respiratory physicians, pulmonary radiologists, and pulmonary pathologists. IP patterns on HRCT and lung specimens were classified based on the international classification statement/guideline for idiopathic interstitial pneumonias. The most frequent form of SLE-IP at diagnosis was chronic IP (63.6%), followed by subacute (20.0%), and acute IP (12.7%). Radiologically, the most common HRCT pattern was "Unclassifiable" (54%). Histologically, "Unclassifiable" was the most frequently found (41.7%) among 12 patients with histologically proven IP. Interestingly, accompanying airway diseases were present in nine of these patients (75%). In multivariate analysis, current smoking (hazard ratio [HR] 6.105, p = 0.027), thrombocytopenia (HR 7.676, p = 0.010), anti-double-strand DNA titre (HR 0.956, p = 0.027), and nonspecific interstitial pneumonia (NSIP) + organizing pneumonia (OP) pattern on HRCT (vs. NSIP, HR 0.089, p = 0.023) were significant prognostic factors. In conclusion, chronic IP was the most frequent form of IP in patients with SLE-IP, and "Unclassifiable" was the commonest pattern radiologically and histologically.
Keyphrases
- systemic lupus erythematosus
- disease activity
- prognostic factors
- computed tomography
- high resolution
- respiratory failure
- primary care
- pulmonary hypertension
- rheumatoid arthritis
- magnetic resonance imaging
- end stage renal disease
- magnetic resonance
- newly diagnosed
- ejection fraction
- drug induced
- mass spectrometry
- spinal cord
- artificial intelligence
- acute respiratory distress syndrome
- single molecule
- high speed
- respiratory tract
- mechanical ventilation
- extracorporeal membrane oxygenation
- circulating tumor