Pulmonary Manifestations of Systemic Lupus Erythematosus Among Adults in Aseer Region, Saudi Arabia

Nouf A Alhammadi; Hanan Saeed Alqahtani; Syed Esam Mahmood; Abdulrahman Arif Alshahrani; Abdullaziz Motlaq A Alahmari; Abdullah Rashid Safer Alshahrani; Abdullah Saeed A Badawi; Ali Mohammed Ali Alqahtani; Abdullah Thabet A Alsalem; Mohammed Saeed M Alsultan Alqahtani; Mohammed Ali Gazzan

doi:10.2147/IJGM.S449068

Pulmonary Manifestations of Systemic Lupus Erythematosus Among Adults in Aseer Region, Saudi Arabia

Int J Gen Med. 2024 Mar 15:17:1007-1015. doi: 10.2147/IJGM.S449068. eCollection 2024.

Affiliations

¹ Department of Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
² Department of Internal Medicine and Rheumatology, Aseer Central Hospital, Abha, Saudi Arabia.
³ Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia.
⁴ College of Medicine, King Khalid University, Abha, Saudi Arabia.

^# Contributed equally.

Abstract

Background: Nearly half of the Systemic lupus erythematosus (SLE) patients develop lung involvement. The study assessed the extent of pulmonary involvement among SLE patients and to identify the associated factors in the population.

Methodology: This retrospective cohort study was conducted at Aseer Hospital and Khamis Myshat Hospital in the Southern region of Saudi Arabia. The study spanned from January 1, 2016, to June 3, 2023. Patient inclusion criteria encompassed individuals who received a definitive diagnosis and classification as per American College of Rheumatology criteria, while patients under 18 years of age and those with mixed connective tissue diseases were exclude.

Results: A total of 247 participants were included. 41.7% (n=103) aged 41 years and older, 95.1% (n = 235) were females. Around 10.10% had diabetes mellitus and 17.00% had hypertension and hypothyroidism. Lupus Nephritis was in 15.40%. Chest involvement was reported in 21.9%, in the form of pleuritis (6.10%), pleural effusion (4.00%), and lupus pneumonitis (4.00%), interstitial lung disease (4.00%), pulmonary embolism (3.60%) of individuals, and pulmonary hemorrhage (2.80%). The respiratory symptoms reported by SLE were; dyspnea, cough, and chest pain each having a prevalence of around 18.0%. Palpitations have a relatively high occurrence at 13.80%. Meanwhile, hemoptysis (blood coughing) has a lower prevalence of 1.20%, and fever is reported at 2.80%. Having chronic kidney disease and hypertension were significantly associated with having pulmonary involvement; (χ2=3.308, p=0.027) and (χ2=7.782, Fisher's p=0.002) respectively. The seropositivity for antiphospholipid Abs, anti-CCP, and antids-DNA were significantly associated with pulmonary involvement (χ2=3.239, =p=0.049), (χ2=4.621, Fisher's p=0.023), and (χ2=8.248, p=0.010) respectively.

Conclusion: The study found that 21.9% of SLE patients experience chest involvement, with varying degrees of pulmonary symptoms. Factors such as chronic kidney disease, hypertension, antiphospholipid antibodies, Anti-CCP positivity, and seropositivity for Anti-dsDNA were found to be significant associations with lung involvement, contributing to our understanding of SLE.

Keywords: ANA; Anti-dsDNA antibodies; Systemic lupus erythematosus; pulmonary manifestation.

Grants and funding

The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for funding this work through large group Research Project under grant number RGP2/263/44.