PO:17:254 | Systemic lupus erythematosus with pulmonary involvement: clinical insights from an Albanian cohort

Arbi Pecani¹, Arian Mezini², Loreta Karaulli², Laert Gjati², Silvana Bala² | ¹Reumatologia, Dipartimento di Medicina Interna, Università di Medicina di Tirana, Ospedale Universitario Shefqet Ndroqi, Tirana; ²Pneumologia, Dipartimento di Medicina Respiratoria, Ospedale Universitario Shefqet Ndroqi, Tirana, Albania

Background. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can significantly affect the lungs leading to irreversible damage, resulting in reduced life quality and varied mortality rates. It can impact all parts of the lung although respiratory symptoms display later. Despite the high frequency, lung involvement in SLE remains understudied.

Objectives. To evaluate the extent of pulmonary involvement in SLE patients and identify factors associated with its occurrence and severity.

Materials and Methods. A retrospective cohort study from January 2024 to January 2025 was conducted at our hospital, including SLE patients >18 years old, fulfilling the ACR and/or SLICC diagnostic criteria. Data regarding demographics, disease, pulmonary involvement, and laboratory markers were extracted from the hospital records. R software version 4.2 was used to carry out statistical analysis.

Results. 45 SLE patients were included; 44.4% (n = 20) were aged 41 years and older, 93.4% (n = 42) females. Around 17.7% had Kidney Disease (KD), 11.1% had hypertension, 4.4% had diabetes and 2.2% had hypothyroidism and deep vein thrombosis. Pulmonary involvement was present in 22 (48.8%) SLE patients, in the form of pleural effusion (45.5%), interstitial lung disease (13.6%), lupus pneumonitis (13.6%), pleuritic (13.6%), pulmonary embolism (9.3%) and pulmonary hemorrhage (4.5%). The most frequent respiratory symptoms reported by SLE patients were: dyspnea (25%), chest pain (20%), and cough (20%) while fever (16.7%), palpitation (13.8%), and hemoptysis (4.5%) were less frequent. KD and hypertension were significantly associated with pulmonary involvement; (χ2=3.307, p=0.026) and (χ2=7.762, p=0.02), respectively. Even the seropositivity for ANA, anti-DNA (ds), and low C4 were significantly associated with pulmonary involvement, (χ2=3.237, p=0.021), (χ2=4.672, p=0.023) and (χ2=8.2467, p=0.01), respectively.

Conclusions. More than one-fifth of SLE patients develop pulmonary complications with pleural effusion being the most common manifestation. Dyspnea, chest pain, and cough are the most frequent respiratory symptoms reported in these patients. KD, hypertension, seropositivity for ANA and anti-DNA (ds) with low C4 were significantly associated with lung involvement. This study provides valuable insights into factors linked to pulmonary involvement in SLE further contributing to a better understanding of this complex autoimmune disease toward proactive management to improve patient outcomes.