title: Subclinical pulmonary abnormalities in childhood-onset systemic lupus erythematosus patients.
abstract: OBJECTIVE
  The aims of this study were to analyze the pulmonary function of childhood-onset systemic lupus erythematosus (cSLE) patients and to identify possible correlations between the high-resolution computed chest tomography (HRCT) score, disease activity, disease cumulative damage, and the participants' quality of life.
  
  
  METHODS
  Forty cSLE patients, median age: 14.1 years (range: 7.4-17.9), underwent spirometry and plethysmography. Carbon monoxide diffusing capacity (DLCO), HRCT, disease activity, disease cumulative damage, and quality of life were assessed.
  
  
  RESULTS
  Pulmonary abnormalities were evident in 19/40 (47.5%) cSLE patients according to spirometry/DLCO. Forced expired volume in one second (FEV1%) was the parameter most affected (30%). The HRCT showed some abnormality in 22/30 patients (73%), which were minimal in 43%. Signs of airway affects were found in 50%. Twelve patients were hospitalized due to cSLE-related pulmonary complications before the study began (median discharge: 2.1 years earlier). Total lung capacity (TLC%), vital capacity (VC%), forced vital capacity (FVC%), and FEV1% were significantly lower in the group with hospitalization compared to the group without hospitalization (p = 0.0025, p = 0.0022, p = 0.0032, and p = 0.0004, respectively). Of note, DLCO was positively correlated with disease duration (r = +0.4; p = 0.01). The HRCT-score was negatively correlated with FEV1/VC (r = -0.63; p = 0.0002), FEV1 (r = -0.54; p = 0.018), FEF25%-75% (r = -0.67; p < 0.0001), and HRCT-score was positively correlated with resistance (r = +0.49; p = 0.0056).
  
  
  CONCLUSIONS
  Almost half of patients with cSLE had subclinical pulmonary abnormalities, especially airway abnormalities. The cSLE-related pulmonary complications seem to determine long-term functional damage.
authors: Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil csveiga1@gmail.com.
authors: C S
authors: CS
authors: Veiga
authors: Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: D S
authors: DS
authors: Coutinho
authors: Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: C M A
authors: CM
authors: Nakaie
authors: Pediatric Rheumatology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: L M A
authors: LM
authors: Campos
authors: Department of Radiology, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: L
authors: L
authors: Suzuki
authors: Physical Therapy Service, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: M T
authors: MT
authors: Cunha
authors: Department of Maternal and Child Health, College of Public Health, University of São Paulo, Brazil.
authors: C
authors: C
authors: Leone
authors: Pediatric Rheumatology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: C A
authors: CA
authors: Silva
authors: Pediatric Pulmonology Unit, Instituto da Criança do Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors: J C
authors: JC
authors: Rodrigues
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002248:Carbon Monoxide / Q000378:metabolism; D002648:Child; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000503:physiopathology; D008297:Male; D010991:Plethysmography; D011788:Quality of Life; D012129:Respiratory Function Tests; D013147:Spirometry; D014057:Tomography, X-Ray Computed / Q000379:methods; D014797:Vital Capacity
chemical_list: D002248:Carbon Monoxide
keywords: Systemic lupus erythematosus; anti-DNA antibodies; vasculitis