Pulmonary function in systemic lupus erythematosus is related to distinct clinical, serologic, and nailfold capillary patterns

Groen, Henk; Borg, E. J. Ter; Postma, Dirkje S.; Wouda, A. A.; Mark, T W van der; Kallenberg, Cees G. M.

doi:10.1016/0002-9343(92)90194-g

Cited by 54 publications

(32 citation statements)

References 31 publications

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“…However, this observation was not confirmed in later studies, which described only an association between low DL,CO and anti-U1 ribonucleoprotein (RNP) antibodies [169].…”

Section: Serum Biomarkersmentioning

confidence: 79%

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement: Table 1—

Antoniou¹,

Margaritopoulos²,

Economidou³

et al. 2009

Eur Respir J

151

122

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The connective tissue disorders (CTDs), also called collagen vascular diseases (CVDs), represent a heterogeneous group of immunologically mediated inflammatory disorders with a large variety of affected organs. Individuals with a CTD (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, polymyositis/dermatomyositis and mixed connective tissue disease) are susceptible to respiratory involvement. When the lungs are affected, an increasing mortality and morbidity in CVDs occurs. Interstitial lung disease (ILD) is established as a clinical corollary across the spectrum of CTDs, with an overall incidence estimated at 15%.Therefore, pivotal clinical dilemmas remain in the evaluation and management of ILD involvement in CVDs. Critical questions are the presence of fibrosis and whether the disease is clinically significant. Moreover, the clinician has to decide if treatment is warranted and which is the best therapeutic approach. The use of additional tests, such as pulmonary function tests, high-resolution computed tomography scan, bronchoalveolar lavage fluid and surgical lung biopsy, deserves better discussion. The present review focuses on establishing the diagnosis of ILD in CTD, and on evaluating disease activity and prognosis. This will provide the basis for therapeutic decisions that will be discussed, including an overview of recent advances.

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“…However, this observation was not confirmed in later studies, which described only an association between low DL,CO and anti-U1 ribonucleoprotein (RNP) antibodies [169].…”

Section: Serum Biomarkersmentioning

confidence: 79%

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement: Table 1—

Antoniou¹,

Margaritopoulos²,

Economidou³

et al. 2009

Eur Respir J

151

122

View full text Add to dashboard Cite

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“…6,16 However the diagnostic specifity of the capillaroscopic method is lower in these patients respect to the scleroderma related diseases. 4 Thus all the NC significant findings in SLE seemed to be associated with features such as lung disease, Raynaud's phenomenon, anticardiolipin antibodies and anti-U1-RNP antibodies, correlating with sclerodermarelated forms, or with overlapping diseases.…”

Section: Discussionmentioning

confidence: 98%

Nailfold capillaroscopy changes in systemic lupus erythematosus: correlations with disease activity and autoantibody profile

Riccieri

Spadaro

Ceccarelli

et al. 2005

Lupus

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In systemic lupus erythematosus (SLE) nailfold capillaroscopy (NC) studies have described many different nonspecific patterns. We decided to evaluate NC changes in 44 SLE patients, comparing them with the main clinical, demographic and laboratory parameters, thus to define the real role for NC and its abnormalities in the management of this disease. Fifteen patients (34%) complained of Raynaud's phenomenon; nine of them (20%) showed relevant capillaroscopic changes (capillaroscopic score >1). In details: three patients (6.8%) had loss of capillaries, while 18 (41%) had a capillary length variability, 16 (36.5%) showing shorter and two (4.5%) longer capillaries; tortuous, meandering, bizarre, ramified and/or bushy capillaries were found in 26 (59%), seven (16%), two (4.5%), three (7%) cases, respectively. An irregular distribution of the capillary array was present in six cases (14%) while microhaemorrhages were found in four cases (9%). 4 patients (9%) showed enlarged capillaries and changes of blood flow. A capillaroscopic score >1 was more frequently associated with higher ECLAM (P < 0.005) and SLEDAI (P < 0.01) activity scores, with the presence of anti-cardiolipin (P < 0.04) and anti-Sm (P < 0.04) antibodies, and also with the presence (P < 0.04) and higher titer (P < 0.001) of anti-dsDNA antibodies. No statistically significant correlation was found among the different capillaroscopy findings, age, disease duration, or treatment, nor with any clinical manifestation of the disease, such as cutaneous, renal or neurological. Our findings confirm the importance of the microvascular involvement in SLE. The NC abnormalities seem to be related to the disease activity and to the presence of many different antibodies, highly involved in the expression of SLE. NC proved to be an easy-to-perform noninvasive technique, able to achieve useful data to better evaluate such a pleomorphic disease as SLE.

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“…with respect to their insidious clinical course and their association with extra-ptilmonary signs of microvascular damage [6][7][8]. In addition, lymphocyte alveolitis is a frequent finding in patients both with SLE and with scleroderma who have developed interstitial lung disease |9 I IJ, This suggests a common pathophysiology probably related to cell-mediated immune processes that have been implicated in the pathophysiology of scteroderma [12].…”

Section: Introductionmentioning

confidence: 99%

Bronchoalveolar lavage cell analysis and lung function impairment in patients with systemic lupus erythematosus (SLE)

Groen

Aslander

Bootsma

et al. 1993

Clinical and Experimental Immunology

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SUMMARY We examined the relationship between peripheral blood and bronchoalveolar lavage (BAL.) lymphocyte phenotypes and lung function in 19 patients with SLE. and evaluated their association with disease activity. Lung function assessment showed a mildly restrictive pattern with frequent impairment of transfer factor for carbon monoxide (TLCO) and diffusing capacity of the alveolocapillary membrane (Dm), of late‐expiratory airflow rales and with a high prevalence of increased airway resistance. TLCO, KCO and Dm correlated inversely with the numbers of CD+ cells and CD56+/CD16+/CD3− (NK) cells in BAL. Oxygen radical production, both by stimulated and unslimulated BAL cells and blood polymorphonuclear leucocytes (PMN) was significantly increased in SLE. In comparison with healthy controls, patients with SLE had a lower percentage of CD19+ B cells in the BAL versus an increased percentage of these cells in peripheral blood. HLA‐DR expression on CD4+ and CDS+ lung lymphocytes was markedly increased in SLE. Current SLE disease activity was not associated with changes in BAL or peripheral blood lymphocyte phenotypes. Our data suggest that an ongoing cell‐mediated immune response is present in the lungs in SLE, particularly involving activated CD8+ T cells and CD56+/CD16+/CD3− NK cells. It is associated with up‐regulated local production of oxygen radicals and with impaired pulmonary diffusing capacity. This inflammatory process seems to be independent of general SLE disease activity.

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Pulmonary function in systemic lupus erythematosus is related to distinct clinical, serologic, and nailfold capillary patterns

Cited by 54 publications

References 31 publications

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement: Table 1—

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement: Table 1—

Nailfold capillaroscopy changes in systemic lupus erythematosus: correlations with disease activity and autoantibody profile

Bronchoalveolar lavage cell analysis and lung function impairment in patients with systemic lupus erythematosus (SLE)

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