Prevalence and risk factors for pulmonary arterial hypertension in patients with Systemic Lupus Erythromatosis

Abstract

SLE is an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs. Pulmonary hypertension is a life-threatening complication of SLE. Pulmonary hypertension in SLE has a variety of causes. The aim of this work was to estimate the prevalence and the risk factors of pulmonary arterial hypertension in SLE patients. Our study included 100 patients with SLE who were classified into 2 groups according to presence of PAH as follows: Group I : 61 patients (61%) without PAH (PAP ≤ 30). Group II : 39 patients (39%) with PAH (PAP >30). PAH were found to be prevalent in our lupus patients (39%). In our results, we found that there was a significant age difference between patients with and without PAH. Venous thromboembolism was significantly higher in SLE patients with PAH in comparison to patients without PAH. Patients with PAH had significantly higher frequency of LAC than patients without PAH and also there was positive correlation for pulmonary artery pressure with LAC and that there was a positive correlation between pulmonary artery pressure and SLEDAI. SLE patients with PAH had higher SLICC/ACR damage score than patients without and the result reached a statistical significance difference and also there was positive correlation for PAP with SLICC/ACR damage index. Concerning individual organ affection by SLICC/ACR damage index, only pulmonary and peripheral vascular affection showed significant difference between both groups. Higher percentages of lung diseases and also more frequent abnormality in pulmonary function tests in SLE patients with PAH and were statistically significant compared to SLE without PAH. Also our results of regression analysis showed that lupus anticoagulant and presence of lung disease were the only independent predictors of PAH in SLE.