Pulmonary involvement in juvenile systemic lupus erythematosus: a study on lung function in patients asymptomatic for respiratory disease

Abstract

Pleuro-pulmonary involvement has been well recognized in adults affected with systemic lupus erythematosus (SLE), but few studies have been carried out in children. A longitudinal study on a group of 15 children affected with juvenile SLE (JSLE), asymptomatic for lung disease, was performed, and the prevalence and the features of respiratory function alterations, over a period of 12 months, were analysed. Moreover, a possible correlation between any pulmonary function test (PFT) and disease duration, disease activity, visceral involvement and immunological pattern was evaluated. At baseline, a significant functional lung impairment was present in 40% of patients, with a significantly reduced FVC, V^A and DLCO in 26% of them; in 60% of patients at 6 months and in 33% of patients at 12 months. At 6 and 12 months, our data did not show any significant modification in PFTs and the restrictive pattern, observed at baseline, remained unchanged. No correlation between altered PFTs and disease duration, activity and/or immunological findings was found. At baseline, the presence of neurological involvement was the only extra-pulmonary feature correlated to reduced FVC

Keywords

systemic lupus erythematosus childhood pulmonary function tests

Get full access to this article

View all access options for this article.

References

Dubois EL , Wallace DJ . Clinical and laboratory manifestation in systemic lupus erythematosus. In: Dubois EL , Hahn B (eds) Lupus Erythematosus. Lee and Febiger: Philadelphia, 1994, pp 343–356.

Arnalich F et al. Pulmonary function in Systemic Lupus Erythematosus without respiratory symptoms . Bull Eur Physiopath Resp 1979; 15: 649–657 .

Caeiro FM et al. Systemic lupus erythematosus in childhood . Ann Rheum Dis 1981; 40: 325–331 .

Huang CT , Hennigar GR , Lyons HA . Pulmonary dysfunction in systemic lupus erythematosus . N Engl J Med 1965; 272: 288–293 .

Koerner SK . Pulmonary dysfunction in systemic lupus erythematosus: prevalence, classification and correlations with other organ involvement . J Rheum 1980; 7: 187–195 .

Eichacker PQ et al. Serial pulmonary function testing in patients with systemic lupus erythematosus . Chest 1988; 94: 129–132 .

Grennan et al. Pulmonary involvement in systemic lupus erythematosus . Ann Rheum Dis 1987; 37: 536–539 .

Rolla G et al. Respiratory function in systemic lupus erythematosus: relation with activity and severity . Lupus 1996; 5: 38–43 .

Singsen BH , Platzker CG . Pulmonary involvement in the rheumatic disorders of children. In: Kendig EL , Chernick V (eds) Disorders of the respiratory tract in children. 5th edn. WB Saunders: Philadelphia , 1990: 890–916.

10.

De Jongste JC et al. Respiratory tract disease in systemic lupus erythematosus . Arch Dis Child 1986; 61: 478–483 .

11.

Tan EM , Coeh AS , Fries JF . The 1982 revised criteria for the classification of systemic lupus erythematosus . Arthritis Rheum 1982; 25: 1271–1277 .

12.

Bombardier C et al. Derivation of the SLEDAI. A disease activity index for lupus patients . Arthritis Rheum 1982; 25: 630–640 .

13.

Lebowitz MD , Knudson RJ , Burrows B . Tucson epidemiological study of obstructive lung disease. Methodology and prevalence of disease . Am J Epidemiol 1975; 102: 348–356 .

14.

National asthma education program . Expert panel report of diagnosis and management of asthma. U.S. Government Printing Office, Washington, DC NIH Publication no. 92-2113A, 1991.

15.

Tanner JM . Growth and adolescence. 2nd Edn. Blackwell: Oxford , 1962.

16.

Harris EN , Gharavi AE , Patel SP , Hughes GRV . Anticardiolipin antibodies test: report at International workshop held in April 1986 . Clin Exp Immunol 1987; 68: 215–222 .

17.

Tincani A et al. Antiphospholipid and anti-mitochondrial type M antibodies in SLE . Clin Exp Rheumatol 1985; 3: 321–326 .

18.

Rosenthal M et al. Lung function in white children aged 4 to 19 years. I-Spirometry . Thorax 1993; 48: 794–802 .

19.

Clark EH , Woods RL , Hughes JB . Effect of blood transfusion on the carbon monoxide transfer factor in man . Clin Sci 1978; 54: 627–631 .

20.

Rosenthal M et al. Lung function in white children aged 4 to 19 years. II Single breath analysis and plethismography . Thorax 1993; 48: 803–808 .

21.

Cerveri I et al. Pulmonary function in childhood connective tissue diseases . Eur Respir J 1992; 5: 733–738 .

22.

Cerveri I et al. Pulmonary function in children with systemic lupus erythematosus . Thorax 1996; 51: 424–428 .

23.

Delgado EA , Malleson PN , Pirie GE , Petty RE . The pulmonary manifestations of childhood onset systemic lupus erythematosus . Semin Arthritis Rheum 1990; 19: 285–293 .

24.

Weiss SG , Wegener Weiner L , Newcomb LW . Assessment of pulmonary function in childhood systemic lupus erythematosus . Arthritis Rheum 1984; 27: S63-S63 .

25.

Sant SM , Doran M , Fenelon HM , Breatnach ES . Pleuropulmonary abnormalities in patients with systemic lupus erythematosus: assessment with high resolution computed tomography, chest radiography and pulmonary function tests. Clin Exp Rheumatol 1997; 507–513.

26.

Martens J , Demedts M , Vanmeenen MT , DeQueker J . Respiratory muscle dysfunction in systemic lupus erythematosus . Chest 1983; 84: 170–175 .

27.

Decramer M , Lacquet LM , Fagard R , Rogiers P . Corticosteroid contribute to the muscle weakness in chronic airflow obstruction . Am J Respir Crit Care Med 1994; 150: 11–16 .

28.

Groen H et al. Pulmonary function in systemic lupus erythematosus is related to distinct clinical, serologic and nailfold capillary patterns . Am J Med 1992; 93: 619–627 .

29.

Boulware DW , Hedgpeth MT . Lupus pneumonitis and anti-SSA(Ro) antibodies . J Rheumatol 1989; 16: 479–481 .

30.

Andonopoulos AP et al. Pulmonary function of non-smoking patients with systemic lupus erythematosus . Chest 1988; 94: 312–315 .