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Haye Salinas MJ, Caeiro F, Saurit V, Alvarellos A, Wojdyla D, Scherbarth HR, de O e Silva AC, Tavares Brenol JC, Lavras Costallat LT, Neira OJ, Iglesias Gamarra A, Vásquez G, Reyes Llerena GA, Barile-Fabris LA, Silveira LH, Sauza del Pozo MJ, Acevedo Vásquez EM, Alfaro Lozano JL, Esteva Spinetti MH, Alarcón GS, Pons-Estel BA. Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL). Lupus 2017; 26:1368-1377. [DOI: 10.1177/0961203317699284] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- M J Haye Salinas
- Servicio de Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina
| | - F Caeiro
- Servicio de Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina
| | - V Saurit
- Servicio de Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina
| | - A Alvarellos
- Servicio de Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina
| | - D Wojdyla
- Department of Biostatistics, GLADEL, Rosario, Argentina
| | - H R Scherbarth
- Servicio de Reumatología, Hospital Interzonal General de Agudos “Dr. Oscar Alende” Mar del Plata, Argentina
| | - A C de O e Silva
- Serviço da Reumatología, Facultad de de Medicina, Universida de Federal de Goias, Goiania, Brazil
| | - J C Tavares Brenol
- Serviço de Reumatología, Hospital da Clinicas da Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - L T Lavras Costallat
- Divisao de Reumatología, Faculdade de Ciencias Medicas, Universidade Estadual da Campinas, Campinas, Brazil
| | - O J Neira
- Sección Reumatología, Hospital del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - A Iglesias Gamarra
- Servicio de Reumatología, Hospital San Juan de Dios, Facultad de Medicina, Universidad Nacional, Bogotá, Colombia
| | - G Vásquez
- Servicio de Reumatología, Universidad de Antioquia, Hospital Universitario, Fundación San Vicente, Medellin, Colombia
| | - G A Reyes Llerena
- Servicio de Reumatología, Centro de Investigaciones Médico Quirúrgicas (CIMEQ), La Habana, Cuba
| | - L A Barile-Fabris
- Departamento de Reumatologia, Hospital de Especialidades “Bernardo Sepúlveda”, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguro Social, México D.F. México
| | - L H Silveira
- Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México D.F. México
| | - M J Sauza del Pozo
- Servicio de Reumatología, Instituto Mexicano de Seguro Social, Hospital de Especialidades N° 25, Monterrey, N.L., México
| | - E M Acevedo Vásquez
- Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, ESSALUD, Lima, Perú
| | - J L Alfaro Lozano
- Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, ESSALUD, Lima, Perú
| | - M H Esteva Spinetti
- Unidad de Reumatología, Hospital Central de San Cristobal, San Cristobal, Venezuela
| | - G S Alarcón
- Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - B A Pons-Estel
- Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
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