Juliana Fernandes Sarmento Donnarumma1, Eloara Vieira Machado Ferreira2, Jaquelina Ota-Arakaki2, Cristiane Kayser3,4. 1. Rheumatology Division, Medicine Department, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. 2. Division of Pneumology, Medicine Department, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. 3. Rheumatology Division, Medicine Department, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. criskayser@terra.com.br. 4. Disciplina de Reumatologia da Universidade Federal de São Paulo, Rua Botucatu 740, 3 ° andar, São Paulo, SP, 04023-062, Brazil. criskayser@terra.com.br.
Abstract
BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare and severe complication of systemic lupus erythematosus (SLE). This study aimed to evaluate clinical and laboratory risk factors associated with PAH in SLE patients. METHODS: This was a retrospective case-control study in which patients with SLE with PAH (SLE-PAH) confirmed by right heart catheterization (RHC) were compared with SLE patients without PAH. Clinical and demographic variables related to SLE and PAH and nailfold capillaroscopy were evaluated by reviewing the medical records of the patients. RESULTS: Twenty-one patients with SLE-PAH and 44 patients with SLE without PAH matched for sex and disease duration were included. The scleroderma (SD) pattern on nailfold capillaroscopy was more frequently found in patients with SLE-PAH than in those without PAH (56.3% versus 15.9%, respectively, p = 0.002). By univariate analysis, Raynaud's phenomenon, history of abortion, and SD pattern on capillaroscopy were associated with PAH. Arthritis was a protective factor for PAH development. Multivariate analysis showed that the SD pattern on capillaroscopy was the only variable associated with a significantly higher risk of PAH, with an odds ratio of 6.393 (95% confidence interval, 1.530-26.716; p = 0.011). CONCLUSION: In this study, SD pattern was associated with a 6.3-fold increased risk for PAH development in SLE patients, suggesting that nailfold capillaroscopy might be useful as a screening method to identify SLE patients with a high risk of developing this severe complication.
BACKGROUND:Pulmonary arterial hypertension (PAH) is a rare and severe complication of systemic lupus erythematosus (SLE). This study aimed to evaluate clinical and laboratory risk factors associated with PAH in SLEpatients. METHODS: This was a retrospective case-control study in which patients with SLE with PAH (SLE-PAH) confirmed by right heart catheterization (RHC) were compared with SLEpatients without PAH. Clinical and demographic variables related to SLE and PAH and nailfold capillaroscopy were evaluated by reviewing the medical records of the patients. RESULTS: Twenty-one patients with SLE-PAH and 44 patients with SLE without PAH matched for sex and disease duration were included. The scleroderma (SD) pattern on nailfold capillaroscopy was more frequently found in patients with SLE-PAH than in those without PAH (56.3% versus 15.9%, respectively, p = 0.002). By univariate analysis, Raynaud's phenomenon, history of abortion, and SD pattern on capillaroscopy were associated with PAH. Arthritis was a protective factor for PAH development. Multivariate analysis showed that the SD pattern on capillaroscopy was the only variable associated with a significantly higher risk of PAH, with an odds ratio of 6.393 (95% confidence interval, 1.530-26.716; p = 0.011). CONCLUSION: In this study, SD pattern was associated with a 6.3-fold increased risk for PAH development in SLEpatients, suggesting that nailfold capillaroscopy might be useful as a screening method to identify SLEpatients with a high risk of developing this severe complication.
Authors: Alexandra Arvanitaki; George Giannakoulas; Eva Triantafyllidou; Christos Feloukidis; Afroditi K Boutou; Alexandros Garyfallos; Haralambos Karvounis; Theodoros Dimitroulas Journal: Respir Res Date: 2021-01-21
Authors: Dieneke Schonenberg-Meinema; Sandy C Bergkamp; Amara Nassar-Sheikh Rashid; Mariken P Gruppen; Maritza A Middelkamp-Hup; Wineke Armbrust; Koert Dolman; A Elisabeth Hak; Petra C E Hissink Muller; Marieke van Onna; Joost F Swart; Taco W Kuijpers; Sylvia S M Kamphuis; Vanessa Smith; J Merlijn van den Berg Journal: Lupus Sci Med Date: 2022-02