title: Pulmonary manifestations of systemic lupus erythematosus patients with and without antiphospholipid syndrome.
abstract: OBJECTIVE
  To uncover the pulmonary manifestations of Systemic Lupus Erythematosus (SLE) patients alone and to compare findings with antiphospholipid syndrome (APS) associated with SLE.
  
  
  METHODS
  This cross sectional comparative study was carried out at King Khalid University Hospital (KKUH)/King Saud University (KSU), a tertiary care hospital, Riyadh, Kingdom of Saudi Arabia. From June 2012 to March 2014, 96 diagnosed SLE patients with respiratory symptoms were included in the study and divided into two groups. Group one included SLE without antiphospholipid syndrome (APS) and group two SLE with APS. We compared Demographic features, clinical manifestations and findings of chest X-Ray, Arterial Blood Gases, Pulmonary function tests, six minute walk test, ventilation perfusion scan, echocardiography and chest high resolution computed tomography.
  
  
  RESULTS
  Demographic and clinical characteristics of two groups were similar. Previous history of deep venous thrombosis (3% vs 27.6%, p=0.001), pulmonary embolism (3% vs34.5%, p<0.0001) and abortions (7.5% vs 27.6%, p=0.019) were significantly more in group two. Levels of Anticardiolipin antibody (0% vs 100%, p<0.0001) and lupus anticoagulant (1.5% vs 79.3%, p<0.0001) were also significantly higher in group two. Hypoxemia measured by pulse oximetry (43.3% vs 65.5% p=0.045, pulmonary Arterial Hypertension (15.5% vs 39.3% p=0.014)), and pulmonary embolism (3.4% vs 21.4% p=0.013) and ventilation perfusion mismatch on V/Q scan (1.5% vs 24.1% p=0.001) were more frequent in group two.
  
  
  CONCLUSIONS
  Hypoxemia, pulmonary embolism and pulmonary arterial hypertension were significantly high in SLE patients with APS, requiring long term anticoagulation and treatment and close follow-up.
authors: Muhammad Afzal Hamdani, FCPS, Dip-Card., MRCP. Senior Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Muhammad Afzal
authors: MA
authors: Hamdani
authors: Abdul Rahman Saud Al-Arfaj, MRCP(UK), FRCPC, Professor of Rheumatology, American Board of Internal Medicine, American Board of Rheumatology. Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Abdul Rahman
authors: AR
authors: Saud Al-Arfaj
authors: Khalid Parvez, FCPS. Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Khalid
authors: K
authors: Parvez
authors: Faisal Naseeb, FCPS. Registrar, Division of Rheumatology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Faisal
authors: F
authors: Naseeb
authors: Dr. Abdalla El Fateh Ibrahim, MRCP. Assistant Professor of Pulmonology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Abdalla El Fateh
authors: Ael F
authors: Ibrahim
authors: Joseph Hope Cal, FPCP, FPCCP. Registrar, Division of Pulmonology, Department of Medicine, King Khalid University Hospital (KKUH), King Saud University (KSU), Riyadh, Saudi Arabia.
authors: Joseph Hope
authors: JH
authors: Cal
keywords: Antiphospholipid Syndrome; Pulmonary manifestations. High resolution computed tomography; Systemic Lupus Erythematosus