A Study on Pulmonary Manifestations in Systemic Lupus Erythematous

Narayanaswamy, Y N (2013) A Study on Pulmonary Manifestations in Systemic Lupus Erythematous. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Systemic Lupus Erythematosus is one of the major causes of morbidity for a decade of life and mortality. SLE is a chronic auto immune disease characterized by microvascular Inflammation with the generation of auto antibodies that can affect almost any organ system. Its presentation and course are highly variable SLE and pulmonary manifestations. The majority of patients with SLE develop pleural or pulmonary disease. In the course of their illness, diagnosed clinically and or by images technique. The pleura are the most common thoracic localization of SLE. Record studies with the use of imaging techniques like HRCT chest suggest that not only pleural diseases are common but airway disease lymphadenopathy and interstitial lung diseases are also common than previously thought. HRCT will also be useful in permitting invasive procedures like lung biopsy and bronchodilator lavage to specific site of interest. AIM OF THE STUDY: To study various pulmonary involvement in Systemic lupus erythematosus. MATERIAL AND METHODS: Rheumatology Ward, Outpatient of Medical and Rheumatology O.P. of Rajiv Gandhi Government General Hospital during period from May 2012 to October Systemic Lupus Erythematosus patient admitted in Medical Ward, 2012, were selected for this study. Sample Size: 50 Patients. Study Design: Cross sectional study. Study Population: SLE patient attending medicine and rheumatology op and admitted in Medical and Rheumatology ward. Study Centre: Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. Inclusion Criteria: Patient known case of SLE fulfilling ACR Criteria with disease duration more than 5 years were taken into the study. Exclusion Criteria • Childhood Lupus. • Pregnancy. • Overlap Syndrome. • Mixed Connective Tissue Disorder. • ILD due to occupational lung Disease and other Non-lupus causes. Detailed history was taken from patient according to questionnaire and subjected to thorough clinical examination and Investigations. And even history regarding presence or absence of Lupus Nephritis was taken. METHODOLOGY: Patients with SLE more than 5 years disease duration were taken into the study. Both symptomatic and asymptomatic have been taken into study Respiratory symptoms: Cough with or without expectoration, Dyspnea, Hemoptysis, Pleurisy. Patient were subjected to thorough history and physical examination. RESULTS: In the present study 50 SLE patients were taken into study group Age distribution: The present study observed that 70 per cent of patients of SLE were in 3rd and 4th decade of life, 22 per cent of patients were in 5th decade of life and above. Sex distribution: In our study sex distribution were 92 per cent of female and 8 per cent of male. Duration distribution: The duration distribution of the present study were as follows 38 per cent of patients were between 5 to 10 years of duration, 30 per cent of patients were between 11 to 15 years of duration, 10 per cent of patient were between 16 to 20 years of duration, 18 per cent of patients were between 21 to 25 years of duration, and 4 per cent of patients were between 26 to 30 years of duration. Symptomatic Vs. Asymptomatic: In our study among 50 patients, symptomatic were 22 patients (44%), and asymptomatic were 28 patients (56%) Symptoms distribution: In the present study cough was present in 8 per cent of patients, cough with expectoration was present in 4 per cent of patient, dyspnea was present in 16 per cent of patients, pleurisy was present in 24 per cent of patients, and 32 per cent of patients were asymptomatic. CONCLUSION: 1. SLE and pulmonary manifestation is a common manifestation and it is not a rare manifestation. 2. Pleural effusion with or without pleuritis and interstitial lung disease were of almost equal incidence still pleural effusion was slightly more common. 3. Even in asymptomatic patient with normal chest x ray and pulmonary function, HRCT chest detected pulmonary involvement in significant number of cases. 4. Thus it is important to do HRCT chest even with subtle clinical respiratory symptoms to detect early respiratory involvement and aggressively treat the respiratory manifestation without allowing it to develop into irreversible changes. 5. To concentrate also on pulmonary manifestation of SLE like that of lupus nephritis and not to tapper the immunosuppressive agent dose just by monitoring nephritis but also by monitoring pulmonary manifestation.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Pulmonary Manifestations ; Systemic Lupus Erythematous.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 30 Mar 2018 03:53
Last Modified: 30 Mar 2018 03:53
URI: http://repository-tnmgrmu.ac.in/id/eprint/6778

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