A STUDY OF PULMONARY MANIFESTATIONS IN THE PATIENTS OF SYSTEMIC LUPUS ERYTHEMATOSUS IN A TERTIERY CARE HOSPITAL

BACKGROUND Systemic lupus erythematosus is an autoimmune disorder characterised by multisystem involvement. Pulmonary involvement is common in SLE. Pulmonary manifestations include pleuritis, pleural effusion, interstitial lung disease and shrinking lung syndrome. There are few such studies in India. Hereby, we studied pulmonary manifestations of SLE in a tertiary centre in South India. MATERIALS AND METHODS 50 patients diagnosed to have SLE with disease duration more than 5 years were included in the study. Detailed clinical history and examination was conducted. They were subjected to chest x-ray, high-resolution CT scan, pulmonary function test and sputum examination was done. These patients were screened for various respiratory symptoms. The radiological features and pulmonary function test features were analysed for both symptomatic and asymptomatic patients. Pulmonary manifestations in patients of lupus nephritis was also studied. RESULTS Out of 50 patients, 8% were males and 92% were females. 44% patients were symptomatic and 56% were asymptomatic. In our study, pleuritis with effusion were present in 12 patients (24%), consolidation with effusion were present in 2 patients (4%), asymptomatic pleural effusion were present in 2 patients (4%), symptomatic interstitial lung disease was seen in 3 patients (6%), asymptomatic interstitial lung disease was seen in 10 patients (20%), pneumonitis were present in 3 patients (6%) and asymptomatic mediastinal lymphadenopathy in 2 patients (4%). 50% of the patients having lupus nephritis had pulmonary manifestations. CONCLUSION Pleural effusion and interstitial lung disease were common manifestations. Pleural effusion was slightly more common. Even in asymptomatic patient with normal chest x-ray and pulmonary function, HRCT chest detected pulmonary involvement in significant number of cases. Thus, it is important to do HRCT chest even with subtle clinical respiratory symptoms to detect early respiratory involvement in the patients of SLE