Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort
Abstract Background The purpose of this study was to assess the prevalence, associated factors, and impact on mortality of primary respiratory disease in a large systemic lupus erythematosus (SLE) retrospective cohort. Methods All adult patients in the RELESSER-TRANS (Registry of Systemic Lupus Eryt...
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doaj-4c74968e321340e0b373fc0272eaabe72020-11-24T21:27:19ZengBMCArthritis Research & Therapy1478-63622018-12-0120111010.1186/s13075-018-1776-8Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohortJavier Narváez0Helena Borrell1Fernando Sánchez-Alonso2Iñigo Rúa-Figueroa3Francisco Javier López-Longo4María Galindo-Izquierdo5Jaime Calvo-Alén6Antonio Fernández-Nebro7Alejandro Olivé8José Luis Andreu9Víctor Martínez-Taboada10Joan Miquel Nolla11José María Pego-Reigosa12on behalf of the RELESSER Study GroupDepartment of Rheumatology (Planta 10-2), Servicio de Reumatología, Hospital Universitario de BellvitgeDepartment of Rheumatology (Planta 10-2), Servicio de Reumatología, Hospital Universitario de BellvitgeUnidad de Investigación, Sociedad Española de ReumatologíaHospital Universitario Doctor NegrínHospital Universitario Gregorio MarañónHospital Universitario 12 de OctubreHospital Universitario ArabaHospital Universitario de MálagaHospital Germans Trias i PujolHospital Universitario Puerta de HierroHospital Universitario Marqués de ValdecillaDepartment of Rheumatology (Planta 10-2), Servicio de Reumatología, Hospital Universitario de BellvitgeComplexo Hospitalario Universitario de VigoAbstract Background The purpose of this study was to assess the prevalence, associated factors, and impact on mortality of primary respiratory disease in a large systemic lupus erythematosus (SLE) retrospective cohort. Methods All adult patients in the RELESSER-TRANS (Registry of Systemic Lupus Erythematosus Patients of the Spanish Society of Rheumatology [SER], cross-sectional phase) registry were retrospectively investigated for the presence of primary pleuropulmonary manifestations. Results In total 3215 patients were included. At least one pleuropulmonary manifestation was present in 31% of patients. The most common manifestation was pleural disease (21%), followed by lupus pneumonitis (3.6%), pulmonary thromboembolism (2.9%), primary pulmonary hypertension (2.4%), diffuse interstitial lung disease (2%), alveolar hemorrhage (0.8%), and shrinking lung syndrome (0.8%). In the multivariable analysis, the variables associated with the development of pleuropulmonary manifestation were older age at disease onset (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.02–1.04), higher SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores (OR 1.03, 95% CI 1.00–1.07), the presence of Raynaud’s phenomenon (OR 1.41, 95% CI 1.09–1.84), secondary antiphospholipid syndrome (OR 2.20, 95% CI 1.63–2.97), and the previous or concomitant occurrence of severe lupus nephritis, (OR 1.48, 95% CI 1.12–1.95) neuropsychiatric manifestations (OR 1.49, 95% CI 1.11–2.02), non-ischemic cardiac disease (OR 2.91, 95% CI 1.90–4.15), vasculitis (OR 1.81, 95% CI 1.25–2.62), hematological manifestations (OR 1.31, 95% CI 1.00–1.71), and gastrointestinal manifestations, excluding hepatitis (OR 2.05, 95% CI 1.14–3.66). Anti-RNP positivity had a clear tendency to significance (OR 1.32, 95% CI 1.00–1.75; P = 0.054). The development of pleuropulmonary manifestations independently contributes to a diminished survival (hazard ratio of 3.13). However, not all complications will influence the prognosis in the same way. Whereas the occurrence of pleural disease or pulmonary thromboembolism has a minimal impact on the survival of these patients, the remaining manifestations have a major impact on mortality. Conclusion Except for pleural disease, the remaining respiratory manifestations are very uncommon in SLE (<4%). Pleuropulmonary manifestations independently contributed to a decreased survival in these patients.http://link.springer.com/article/10.1186/s13075-018-1776-8Systemic lupus erythematosusPleuropulmonary involvement |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Javier Narváez Helena Borrell Fernando Sánchez-Alonso Iñigo Rúa-Figueroa Francisco Javier López-Longo María Galindo-Izquierdo Jaime Calvo-Alén Antonio Fernández-Nebro Alejandro Olivé José Luis Andreu Víctor Martínez-Taboada Joan Miquel Nolla José María Pego-Reigosa on behalf of the RELESSER Study Group |
spellingShingle |
Javier Narváez Helena Borrell Fernando Sánchez-Alonso Iñigo Rúa-Figueroa Francisco Javier López-Longo María Galindo-Izquierdo Jaime Calvo-Alén Antonio Fernández-Nebro Alejandro Olivé José Luis Andreu Víctor Martínez-Taboada Joan Miquel Nolla José María Pego-Reigosa on behalf of the RELESSER Study Group Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort Arthritis Research & Therapy Systemic lupus erythematosus Pleuropulmonary involvement |
author_facet |
Javier Narváez Helena Borrell Fernando Sánchez-Alonso Iñigo Rúa-Figueroa Francisco Javier López-Longo María Galindo-Izquierdo Jaime Calvo-Alén Antonio Fernández-Nebro Alejandro Olivé José Luis Andreu Víctor Martínez-Taboada Joan Miquel Nolla José María Pego-Reigosa on behalf of the RELESSER Study Group |
author_sort |
Javier Narváez |
title |
Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort |
title_short |
Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort |
title_full |
Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort |
title_fullStr |
Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort |
title_full_unstemmed |
Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry (RELESSER) cohort |
title_sort |
primary respiratory disease in patients with systemic lupus erythematosus: data from the spanish rheumatology society lupus registry (relesser) cohort |
publisher |
BMC |
series |
Arthritis Research & Therapy |
issn |
1478-6362 |
publishDate |
2018-12-01 |
description |
Abstract Background The purpose of this study was to assess the prevalence, associated factors, and impact on mortality of primary respiratory disease in a large systemic lupus erythematosus (SLE) retrospective cohort. Methods All adult patients in the RELESSER-TRANS (Registry of Systemic Lupus Erythematosus Patients of the Spanish Society of Rheumatology [SER], cross-sectional phase) registry were retrospectively investigated for the presence of primary pleuropulmonary manifestations. Results In total 3215 patients were included. At least one pleuropulmonary manifestation was present in 31% of patients. The most common manifestation was pleural disease (21%), followed by lupus pneumonitis (3.6%), pulmonary thromboembolism (2.9%), primary pulmonary hypertension (2.4%), diffuse interstitial lung disease (2%), alveolar hemorrhage (0.8%), and shrinking lung syndrome (0.8%). In the multivariable analysis, the variables associated with the development of pleuropulmonary manifestation were older age at disease onset (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.02–1.04), higher SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores (OR 1.03, 95% CI 1.00–1.07), the presence of Raynaud’s phenomenon (OR 1.41, 95% CI 1.09–1.84), secondary antiphospholipid syndrome (OR 2.20, 95% CI 1.63–2.97), and the previous or concomitant occurrence of severe lupus nephritis, (OR 1.48, 95% CI 1.12–1.95) neuropsychiatric manifestations (OR 1.49, 95% CI 1.11–2.02), non-ischemic cardiac disease (OR 2.91, 95% CI 1.90–4.15), vasculitis (OR 1.81, 95% CI 1.25–2.62), hematological manifestations (OR 1.31, 95% CI 1.00–1.71), and gastrointestinal manifestations, excluding hepatitis (OR 2.05, 95% CI 1.14–3.66). Anti-RNP positivity had a clear tendency to significance (OR 1.32, 95% CI 1.00–1.75; P = 0.054). The development of pleuropulmonary manifestations independently contributes to a diminished survival (hazard ratio of 3.13). However, not all complications will influence the prognosis in the same way. Whereas the occurrence of pleural disease or pulmonary thromboembolism has a minimal impact on the survival of these patients, the remaining manifestations have a major impact on mortality. Conclusion Except for pleural disease, the remaining respiratory manifestations are very uncommon in SLE (<4%). Pleuropulmonary manifestations independently contributed to a decreased survival in these patients. |
topic |
Systemic lupus erythematosus Pleuropulmonary involvement |
url |
http://link.springer.com/article/10.1186/s13075-018-1776-8 |
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