AB0336 PULMONARY MANIFESTATIONS IN A COLOMBIAN COHORT OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: S. Herrera, J. C. Diaz-Coronado, S. Monsalve, S. Guerra-Zarama, M. F. Saavedra Chacón, J. Barbosa, J. D. Serna Giraldo, J. D. Lopez, J. M. Gutiérrez, T. Vega, D. Orozco, D. Ocampo, N. Zuluaga, D. Hernandez-Parra, D. Rojas-Gualdrón, R. Pineda.Tamayo
Journal: Annals of the Rheumatic Diseases (2021)

Background: Pulmonary manifestations are frequent in systemic lupus erythematosus (SLE) with a frequency of 30-90% that depends on the cohort and the methods used for their identification. The association of this compromise with mortality highlights its importance and the need for biomarkers to adequately predict this complication. We describe the prevalence of pulmonary manifestations, and the clinic and immunoserological characteristics of 551 Colombian patients with SLE Objectives: We performed an observational and analytic study of a retrospective cohort with adult SLE patients who fulfilled the 2012 SLICC classification criteria and that had a history of at least 6 months of the disease. These patients were treated in a specialized center of rheumatology with presence in six cities of Colombia between 2015 and 2018. We excluded pregnant patients and those with incomplete data for our survey. The first clinic consult occurred between 2015 and 2018, being defined as moment one. The follow up one year later was defined as moment two. We obtained 710 registries that were potentially eligible and analyzed 465 patients at moment two after applying the exclusion criteria Methods: In 465 eligible patients, 20,5% had pulmonary compromise (93.8% female) with a median age of 42,4 years. The average SLICC Damage Index of 551 patients with SLE was 0,9 in women and 1.05 in men, while the average SDI of patients with pulmonary compromise was 1. The most frequent manifestation was pleural (14.3%), followed by Lupus pneumonitis (3.6%) and pulmonary hypertension (3.2%). Other manifestations and serological characteristics are recorded in Table 1. Of note, ANA homogeneous pattern was the most common (34.5%), anti-RNP positivity was 41.7%, anti-dsDNA positivity was 53.1% and 53.1% had hypocomplementemia. Results: The prevalence of pulmonary manifestations in our cohort was 20,5%, which is lower that in the previous described GLADEL cohort (28,4%). This could be explained by the regional differences of ethnicities in Latin America and in immune-serological profiles. Anti-RNP positivity was frequent (41.7%) and new pulmonary compromise for one year follow-up was rare. Of not, the mean damage index for our patients with pulmonary manifestations was 1, this could highlight the importance of this organ as a causa of higher damage accrual and mortality, which we will explore in the future Conclusion: The prevalence of pulmonary manifestations in our cohort was 20,5%, which is lower that in the previous described GLADEL cohort (28,4%). This could be explained by the regional differences of ethnicities in Latin America and in immune-serological profiles. Anti-RNP positivity was frequent (41.7%) and new pulmonary compromise for one year follow-up was rare. Of not, the mean damage index for our patients with pulmonary manifestations was 1, this could highlight the importance of this organ as a causa of higher damage accrual and mortality, which we will explore in the future References: [1]G. Aguilera-Pickens, C. Abud-Mendoza. Pulmonary Manifestations in Systemic Lupus Erythematosus: Pleural Involvement, Acute Pneumonitis, Chronic Interstitial Lung Disease and Diffuse Alveolar Hemorrhage. Reumatol Clin. 2018;14(5):294–300. [2]Haye Salinas MJ, Caeiro F, Saurit V. Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL). Lupus (2017) 0, 1–10. [3]Santamaria-Alza Y, Sanchez-Bautista J, Fajardo-Rivero J. Acute respiratory involvement in Colombian patients with systemic lupus erythematosus undergoing chest computed tomography. Int J Rheum Dis. 2019;00:1–7. Table 1. clinical and immunoserological characteristics n % Women 106 93,8 Global mortality 46 8,3 Pulmonary compromise mortality 8 7,1 ANA 104 92 Anti-DNA 60 53,1 ENAS 97,2 Ro 35/87 40,2 La 14/85 16,5 SM 32/88 36,4 RNP 35/84 41,7 Follow up 1 % Follow up 2 % P Value * Pulmonary hypertension 3,2 2,8 0,28 Pulmonary fibrosis 2,14 2,6 1 Shrunken lung 0,2 0,2 1 Pleuritis 14,3 15,05 0,42 Lupus pneumonitis 3,6 3,01 0,85 Alveolar hemorrhage 1,4 1,3 0,76 Pulmonary embolism 2,3 1,93 0,72 Disclosure of Interests: None declared