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Pleural effusions in patients with SLE more often caused by lupus pleuritis than TB
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Pleural effusions in patients with systemic lupus erythematosus are more likely to be caused by lupus pleuritis rather than tuberculosis, even in areas where the latter is endemic, according to study findings.
The medical records of 119 patients with systemic lupus erythematosus (SLE) and 127 episodes of pleuritis in Thailand, where tuberculosis (TB) is endemic, were reviewed. All patients were diagnosed with SLE between 2002 and 2010 using American College of Rheumatology criteria, and pleuritis was identified in the records using ICD-10 codes. The researchers defined “pleuritis” as having either typical pleuritic chest pain, pleural rub, and clinical or radiological evidence of pleural effusion. Most patients (95%) were women, and mean duration of SLE was 4.1 years.
The researchers found pleuritis was the first presentation in 37% of episodes, and pericarditis accompanied pleuritis in 16% of the episodes. Active SLE was present in other systems in 81% of the patients.
Among the causes of pleural effusion, the most common was lupus pleuritis (52%), along with TB pleuritis (9%), parapneumonic effusion (7%) and transudate (15%).
In the 66% of patients who were symptomatic, common symptoms were dyspnea (63%), fever (54%) and nonproductive cough (45%); however, typical pleuritic chest pain was only present in 26% of patients, according to the researchers.
Most of the patients with lupus pleuritis underwent treatment with corticosteroids (93%) or NSAIDs (7%), to which 94% responded with favorable outcomes.
Disclosure: The authors have no relevant financial disclosures.
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