Background Pulmonary diseases are common among patients with Systemic Lupus Erythematosus (SLE) and cover a variety of manifestations including pleuritic disease, airway disease, and interstitial lung disease. Pulmonary diseases among SLE patients are associated with an increased morbidity, mortality and lower health-related quality of life.

Methods Incident cases diagnosed with SLE at Odense University Hospital, Odense, Denmark fulfilling the 2019 EULAR/ACR classification criteria in the period 1. July 2023 to 1. July 2024 are enrolled approximately three months after the date of diagnosis. Blood samples are collected during the three months. At a visit day, they will undergo:

• Pulmonary function testing (PFT)

• High Resolution Computed Tomography scan of Thorax (HRCT)

• Thoracic and Diaphragmatic Ultrasound

• Questionnaire (SLAQ)

• Clinical assessment

Results Five participants are enrolled by March 1, 2024. We report on baseline characteristics, including age, sex, smoking status, disease scores, circulating biomarkers, and findings of the above-mentioned investigations. Results are shown in table 1. Among the newly diagnosed participants, one had pleural fibrosis and bronchiectasis, and one had bronchiectasis. Thoracic ultrasound was able to find pleural disease in the patient with pleural disease, figure 1.

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Abstract LBP4 Figure 1

Thoracic ultrasound. A. Patient with pleural fibrosis. Wide arrow showing thickened irregular pleura. Thin arrow showing b-lines. B. Patient with no pulmonary disease.

Conclusions Significant pulmonary disease is demonstrated in incident SLE cases and we believe that the pulmonary findings are a result of the ongoing autoimmune disease. This is in accordance with the knowledge that autoimmune processes are often initiated before SLE is diagnosed. The results show that thoracic ultrasound is a useful tool for identifying some pulmonary diseases in patients with SLE.