Clinical and serologic factors associated with lupus pleuritis.
OBJECTIVE
Pleuritis is a common manifestation and independent predictor of mortality in systemic lupus erythematosus (SLE). We examined the prevalence of pleuritis and factors associated with pleuritis in a multicenter Canadian SLE cohort.


METHODS
We studied consecutive adults satisfying the American College of Rheumatology (ACR) classification criteria for SLE who had a completed Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) score, at least 1 evaluable extractable nuclear antigen assay, and either a SLE Disease Activity Index (SLEDAI) or a SLE Activity Measure score. Pleuritis was defined as having pleuritis by satisfying the ACR criteria or the SLEDAI. Factors related to pleuritis were examined using univariate and multivariate logistic regression.


RESULTS
In our cohort of 876 patients, 91% were women, 65% Caucasian, mean age (+/- SD) was 46.8 +/- 13.5 years, and disease duration at study entry was 12.1 +/- 9.9 years; the prevalence of pleuritis was 34% (n = 296). Notably, greater disease duration (p = 0.002), higher SDI score (p <or= 0.0001), age at SLE diagnosis (p = 0.009), and anti-Sm (p = 0.002) and anti-RNP (p = 0.002) seropositivity were significantly associated with pleuritis. In multivariate analysis with adjustment for disease duration, age at diagnosis, and SDI score, concomitant seropositivity for RNP and Sm were related to a nearly 2-fold greater prevalence of pleuritis (OR 1.98, 95% CI 1.31-2.82).


CONCLUSIONS
Pleuritis occurred in one-third of this Canadian cohort. Concomitant Sm and RNP seropositivity, greater cumulative damage, longer disease duration, and younger age at SLE disease onset were related to a higher rate of SLE pleural disease.
Mittoo
Shikha
S
Department of Medicine, University of Manitoba, Manitoba, Canada. shikha.hopkins@gmail.com
Gelber
Allan C
AC
Hitchon
Carol A
CA
Silverman
Earl D
ED
Pope
Janet E
JE
Fortin
Paul R
PR
Pineau
Christian
C
Smith
C Douglas
CD
Arbillaga
Hector
H
Gladman
Dafna D
DD
Urowitz
Murray B
MB
Zummer
Michel
M
Clarke
Ann E
AE
Bernatsky
Sasha
S
Hudson
Marie
M
Tucker
Lori B
LB
Petty
Ross E
RE
Peschken
Christine A
CA
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001323:Autoantibodies / Q000276:immunology*; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000453:epidemiology* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010998:Pleurisy / Q000150:complications / Q000453:epidemiology* / Q000276:immunology*; D015995:Prevalence; D012044:Regression Analysis; D012720:Severity of Illness Index
D001323:Autoantibodies