THU0244 PULMONARY MANIFESTATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: PLAZA NAHIA, María José Pérez, Sergio Rodríguez Montero, Carmen Trapero, Jose Luis Marenco
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by inflammation and tissue damage mediated by the immune system. Respiratory manifestations are common in SLE, appearing in up to 50% of patients throughout their lives. Furthermore, it is associated with higher mortality. <h3>Objectives:</h3> To describe the prevalence and characteristics of pulmonary involvement in patients with SLE <h3>Methods:</h3> Observational, descriptive, cross-sectional, retrospective study performed in patients with SLE in follow-up by the Rheumatology Department of Valme Hospital. The following information is collected from medical records; age, sex, mean age at diagnosis, characteristics of pleuropulmonary involvement and ANA and antiDNA positivity. <h3>Results:</h3> We studied 165 patients with SLE, with mean age of 37.01 +/- 14.65 years, predominance of the female patients 153 (92.72%). Thirty eight of them had pulmonary involvement (23.03%), with a total of 47 episodes related to lung manifestations. Mean age at diagnosis was 39.70 +/- 15.50 years. Below is shown information about lung involvement: Eleven patients (28.94%) presented pulmonary involvement at the time of diagnosis; pleuritis (10.63%) and only one case of interstitial lung disease, varicella pneumonia, shrinking lung syndrome, pulmonary embolism (PE) and bronchiolitis obliterans with organizing pneumonia. Two patients (4.24%) died due to severe respiratory failure secondary to bilateral pneumonia. Three of the 5 patients with PE were diagnosed with antiphospholipid syndrome secondary to SLE. Regarding treatment, most of patients who required hospitalization were in basic treatment with synthetic DMARDs (78.57% in monotherapy and 21.43% with double therapy) and only 2 patients with biologic DMARDs (Rituximab and etanercept). Six patients had no treatment because the pulmonary event was at time of diagnosis, 2 patients were with antiaggregating therapy and there was no information registered in two patients (episode before 1997). 91.10% of the patients presented positive for ANA, of which 37.14% (13 patients) also presented positive antiDNA. No information was collected about autoimmunity in one patient (2.12%). <h3>Conclusion:</h3> Pulmonary involvement in SLE is prevalent, although a significant proportion may remain asymptomatic. The little prevalence of pulmonary manifestations in our series might be due to low mean age, according to the result of a recent systematic review where analysed more than 10000 patients and concluded pulmonary manifestations are more frequent in late-onset SLE. The differential diagnosis is broad and the infectious cause, the main cause of mortality in patients with SLE, must always be ruled out. <h3>References:</h3> [1] 10.1016/j.semarthrit.2018.01.010 [2] 10.1016/j.reuma.2018.03.012 [3] 10.1186/s13075-018-1776-8 [4] 10.1097/BOR.0000000000000531 <h3>Acknowledgement:</h3> None <h3>Disclosure of Interests:</h3> NAHIA PLAZA: None declared, MARÍA JOSÉ PÉREZ: None declared, Sergio Rodríguez Montero: None declared, CARMEN TRAPERO: None declared, Jose Luis Marenco Speakers bureau: abbie, pfizer, novartis, janmsen