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Abstract
Objective Tissue calcifications or calcinosis have been described to occur in a variety of systemic autoimmune diseases, even being a significant part of the clinical picture for example in systemic sclerosis or dermatomyositis. In Systemic Lupus Erythematosus (SLE), various types of calcinoses have been described on a case basis, mainly including spleen, serosa, and skin. The clinical significance hereof is unknown. This study aimed to provide controlled, systematic data on the occurrence and locations of various organ calcifications in the thoracic/upper abdominal region.
Methods For this cross-sectional matched case-control study, 110 SLE patients from the PLUSheart (Prospective Lupus Study on Cardiovascular Risk Factors) cohort established at Copenhagen University Hospital, Denmark, in 2012–13 were matched 1:1 by age, sex, and ethnicity to healthy population controls (HC) from the Copenhagen General Population Study (CGPS) cohort. Organ calcifications were evaluated as part of a study on coronary artery calcification using a non-contrast, prospectively ECG-gated cardiac protocol on a 320-multidetector CT scanner. Phases were reconstructed in 3.0 mm slice thickness with 3.0 mm increment. Organ calcifications were noted for the pericardium, bronchi, spleen, and thymus (figure 1).
Results The SLE patients for HC-matching consisted of 90% women and 95% of North European ancestry with a median age and disease duration of 50 years (range 39–75) and 16.5 years (IQR: 1.7–41), respectively. The two groups did not differ in hypertension (≥140/90), obesity (BMI ≥30), dyslipidemia, or diabetes mellitus (p>0.05). However, more SLE patients had mild renal impairment (CKD stage >1) and a history of ever-smoking than HC (p=0.02). Organ calcifications were observed in 51 subjects with SLE patients more often having calcifications in one or more of the investigated organs compared to HC (OR: 4.7 [CI: 2.3–9.8], p<0.0001), table 1).
Conclusion Organ calcifications in the thoracic/upper abdominal region were observed three times more often in SLE patients compared to HC. The significance of these non-vascular organ calcifications remains to be clarified but may be of pathologic significance.
Acknowledgments The Danish Rheumatism Association.
Female SLE patient aged 59 years with signs of bronchial (A) and splenic (B) calcification.
Distributions of non-vascular organ calcifications in patients with systemic lupus erythematosus (SLE) and healthy population controls (HC)
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