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AB0709 Pulmonary arterial hypertension in systemic lupus erythematosus: a study of 80 tunisian patients
  1. S. Sayhi1,
  2. F. Ajili1,
  3. T. Filali2,
  4. I. Gharsallah1,
  5. L. Metoui1,
  6. N. Ben Abdelhafidh1,
  7. J. Laabidi1,
  8. F. Msadak1,
  9. B. Louzir1,
  10. H. Haouala3,
  11. S. Othmani1
  1. 1Department of Internal Medicine
  2. 2Department of Cardiology
  3. 3Department of Cardiology, Military Hospital of Tunis, Monfleury, Tunisia

Abstract

Background Pulmonary hypertension (PH) is a serious form of pulmonary complication that occurs in Systemic lupus erythematosus (SLE). It is less frequent in SLE compared to systemic sclerosis. The symptoms of PH in SLE are non-specific and so it is under-recognized.There are several potential causes of PH in SLE including thromboembolic disease, pulmonary vasculitis, hypoxia and fibrosis due to interstitial lung disease. The treatment is based on a combination corticosteroid and immunosuppressive. Anticoagulants are indicated in cases of anti phospholipid syndrome (APS).

Objectives This study aim is to estimate the prevalence of PH in SLE detected by echocardiography.

Methods This is a retrospective study of 80 patients with SLE fulfilling the criteria of the ACR (American College of Rheumatology), followed in the Department of Internal Medicine of the Military Hospital of Tunis from 2000 to 2010. Echocardiography with measurement of pulmonary artery pressure was performed in 72 patients. A mean pulmonary artery pressure above 30 mm Hg was used to define a PH.

Results Ten patients (7%) had a pulmonary artery pressure more than 30 mmHg. Two of them had lung disease (the first one emphysematous lung and the other interstitial lung disease due to SLE). Three patients had mitral regurgitation. An anti phospholipid syndrome (APS) was noted in 4 cases (40%). Five other patients with SLE had a single PAH (50%). Anti-Sm antibodies were positives in 3 cases.

Conclusions PH is a rare complication of SLE. Its detection is based on echocardiography. Its prognosis is poor and experts suggest that the underlying SLE should be aggressively treated with immunosuppressive therapy in addition to PH-specific treatment.

  1. N. Galie, A. Torbicki, R. Barst, P. Dartevelle, S. Haworth, T. Higenbottam et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The task force on diagnosis and treatment of pulmonary arterial hypertension of the european society of cardiology. Eur Heart J, 25 (2004), pp. 2243–2278

  2. E. Badui, D. Garcia-Rubi, E. Robles, J. Jimenez, L. Juan, M. Deleze et al. Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. Angiology, 36 (1985), pp. 431–441

  3. L. Fauchier, P. Goupille, D. Babuty, C. Marchal, J.P. Valat, J.P. Fauchier et al. Precapillary pulmonary arterial hypertension disclosing systemic lupus erythematosus. Arch Mal Coeur Vaiss, 89 (1996), pp. 477–480

Disclosure of Interest None Declared

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