title: Clinical and serologic factors associated with lupus pleuritis.
abstract: 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.
authors.affiliation: Department of Medicine, University of Manitoba, Manitoba, Canada. shikha.hopkins@gmail.com
authors.forename: Shikha
authors.initials: S
authors.lastname: Mittoo
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
authors.forename: Carol A
authors.initials: CA
authors.lastname: Hitchon
authors.forename: Earl D
authors.initials: ED
authors.lastname: Silverman
authors.forename: Janet E
authors.initials: JE
authors.lastname: Pope
authors.forename: Paul R
authors.initials: PR
authors.lastname: Fortin
authors.forename: Christian
authors.initials: C
authors.lastname: Pineau
authors.forename: C Douglas
authors.initials: CD
authors.lastname: Smith
authors.forename: Hector
authors.initials: H
authors.lastname: Arbillaga
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
authors.forename: Murray B
authors.initials: MB
authors.lastname: Urowitz
authors.forename: Michel
authors.initials: M
authors.lastname: Zummer
authors.forename: Ann E
authors.initials: AE
authors.lastname: Clarke
authors.forename: Sasha
authors.initials: S
authors.lastname: Bernatsky
authors.forename: Marie
authors.initials: M
authors.lastname: Hudson
authors.forename: Lori B
authors.initials: LB
authors.lastname: Tucker
authors.forename: Ross E
authors.initials: RE
authors.lastname: Petty
authors.forename: Christine A
authors.initials: CA
authors.lastname: Peschken
mesh_terms: 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
chemical_list: D001323:Autoantibodies