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Objectives SLE is a multisystemic autoimmune disease. Pleuropulmonary (PP) manifestations, including pleural effusion (PE), interstitial lung disease (ILD), pulmonary hypertension (PH), shrinking lung syndrome (SLS), and alveolar hemorrhage (AH) have been described; however, data on their frequency and associated risk factors are scarce in the Latin American SLE population. A better understanding of PP manifestations in this population is crucial due to the risk of severe and irreversible damage, and impact on morbidity, mortality, and quality of life.Methods Patients from the Latin American GLADEL 2.0 cohort who met the ACR/EULAR 2019 and/or the SLICC SLE classification criteria were included. Patients with PP manifestations (PE/ILD/PH/SLS/AH) were compared to those without PP manifestations. Patients with polyautoimmunity where the disease could have another explanation, were excluded. Univariate (UV) analyses were conducted to determine associations for each PP manifestation, using data recorded prior to the report of the manifestation. Multivariate (MV) logistic regression analyses were performed, adjusting for age, gender, and other variables found to be significant in UV analyses (P<0.05).Results From 1,083 patients in the cohort, 242 patients with PE, 38 with ILD, 26 with PH, 20 with SLS, and 9 with AH were identified. Factors associated with each manifestation, except for AH (due to small n), are summarized in table 1. Age at diagnosis, disease duration, history of renal involvement (active and inactive nephritis), and degree of organ damage, assessed with the SLICC Damage Index (SDI), were frequently associated with PP manifestations. In the MV analysis, the association between SDI and PP remained statistically significant for all complications. Disease activity (per SLEDAI-2K) was only found to be significant for PE (P=0.001). Significant associations between the presence of serositis and PH (P=0.005) and SLS (P=0.001) were found.Abstract PO:03:085 Table 1Conclusions Damage (per SDI), was a consistent risk factor associated with PP manifestations; this risk factor has not been previously reported for PP in SLE. These data highlight the importance of close monitoring for PP in patients with SLE who have organ damage. Additionally, serositis significantly increased the risk of developing PH and SLS in this cohort, consistent with data reported in previous studies.