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79 Clinical characteristics of patients with systemic lupus erythematosus complicated with pulmonary thromboembolism
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  1. Hong Zhu,
  2. Yu-Jia Jing,
  3. Yan Zhou and
  4. Yao Chen
  1. Department of Rheumatology, General Hospital of Ningxia Medical University. Yinchuan 750004, China

Abstract

Background There is strong evidence for an association between SLE and an increased risk of pulmonary thromboembolism (PTE).PTE occurs with a higher frequency in SLE patients compared to the general population.

Methods A retrospective analysis of 29 SLE patients with PTE admitted to our hospital from January 2009 to August 2018 was conducted.

Results Among the 29 patients, 26 (89.66%) were female and 3 (10.34%) were male. The age ranged from 23 to 66 years.The SLEDAI scores of 29 cases ranged from 0 to 18, with scores 15 points in 1 case (3.45%), 10–14 points in 9 cases (31.03%), 5–9 points in 11 cases (37.93%), 0–4 points in 8 cases (27.59%).Among the 29 patients, 13 patients (44.83%) were admitted to the hospital with chest pain or dyspnea as the first symptom. Only one case (3.45%) was admitted to the hospital with hemoptysis as the first symptom.Of the 29 patients, 21 (72.41%) had chest pain or difficulty breathing during the course of the disease.Among the 29 patients, 13 cases (44.83%) had SLE at the initial diagnosis, and the remaining 16 cases (55.17%) had SLE duration ranging from 1 month to 20 years, 3 (18.75%) in one year and 7 (43.75%) in 1 to 10 years. The course of disease was more than 10 years in 6 cases (37.50%).In this group of patients, 1 case (3.45%) with cerebral infarction, 2 cases (6.90%) with renal vein thromboembolism, and 14 cases (48.28%) with lower extremity venous thrombosis.Of the 29 patients, 3 were normal D-D dimers (normal value 0–0.55 mg/L), and the remaining 26 (89.66%) were elevated, with an average of 4.50 mg/L.All patients underwent echocardiography, 14 of whom (48.28%) indicated pulmonary artery widening. Of the 29 patients, 3 patients did not receive anticardiolipin antibodies, and of the remaining 26, 13 were positive and 13 were negative.In terms of prognosis,3 of 10 patients (10.34%) died.

Conclusions SLE combined with PTE is easily missed and misdiagnosed. The clinical manifestations are not typical. In the active stage of SLE, or patients have chest pain and dyspnea symptomsthe, or test indicates that D-D dimer is elevated, or echocardiography indicates pulmonary artery widening, clinicians should think that it might be SLE merge PTE.For patients with anticardiolipin antibody negative, systemic lupus erythematosus should not be relaxed.During the treatment of patients with SLE combined with PTE,they should be alert to the occurrence of thrombosis in other sites.

Funding Source(s): NO

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