Session Type: Abstract Submissions (ACR)
In a previous study, performed 9±3.6 years ago 74 asymptomatic patients with systemic lupus erythematosus (SLE) and or antiphospholipid syndrome (APS) who fulfilled the ACR criteria for diagnosis, underwent lung function testing. A significantly low diffusion capacity (DLCO) ranging from 45% to 70% was recorded in 28 of the 74 (37.8%) patients who were all free of respiratory symptoms. This study aims to assess the clinical importance and predictive value of a low diffusion capacity in asymptomatic patients with SLE or APS.
Asymptomatic patients with SLE and /or APS who were found to have a low DLCO in the previous study were contacted. Of the 28 patients, 15 were recruited and reevaluated in the current study [SLE with APS (n=7), SLE without APS (n=7); primary APS (n=1)]. A detailed history, physical examination, nail bed capillaroscopy, current laboratory tests and lung function tests including DLCO were obtained.
During a surveillance period of 9±3.6 years none of the patients developed lung disease. Diffusion capacity corrected for alveolar volume (DLCO/VA) improved in the study group during this period from 61.3% ± 6.3 to 77% ± 12.7% (p=0.006). Lung function tests including total lung capacity (TLC) and forced expiratory volume in 1s (FEV1) remained within normal limits. Capillaroscopy studies did not reveal changes compatible with scleroderma in any of the patients.
Low diffusion capacity findings on lung function testing does not have a positive predictive value for the development of future lung disease in patients with SLE who are free of respiratory symptoms. Our results suggest that a finding of low diffusion capacity in asymptomatic patients with SLE does not necessarily require further evaluation and imaging and may improve spontaneously over time. Further studies in a larger group of patients are needed to validate these findings.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/decreased-lung-diffusion-capacity-in-asymptomatic-patients-with-systemic-lupus-erythematosus-does-not-predict-future-lung-disease/