HIGH-RESOLUTION CHEST CT IN SYSTEMIC LUPUS-ERYTHEMATOSUS

OBJECTIVE. The purpose of our study was to identify high-resolution CT (HRCT) findings in patients with systemic lupus erythematosus (SLE) a nd to determine their significance by correlation with clinical findin gs, plain chest radiography, and pulmonary function testing. SUBJECTS AND METHODS. Thirty-four patients with documented SLE were prospective ly studied. All patients had plain chest radiography (posteroanterior and lateral), thoracic spiral CT, HRCT, and pulmonary function testing performed. RESULTS. HRCT abnormalities were identified in 24 patients (70%), pulmonary function abnormalities were present in only 14 patie nts (41%), and the plain chest radiograph was abnormal in only 8 patie nts (24%). The most common CT findings were: interstitial lung disease (n = 11), bronchiectasis (n = 7), mediastinal or axillary lymphadenop athy (n = 6), and pleuropericardial abnormalities (n = 5). No correlat ion was found between disease activity, duration of disease, chest sym ptoms, drug therapy, smoking history, and the presence of abnormal HRC T findings. More importantly, no correlation was found between pulmona ry function abnormalities and the presence or grade of interstitial lu ng disease or bronchiectasis as determined by HRCT. CONCLUSION. The re sults of this study, the first to describe the HRCT findings in SLE, s uggest that airways disease, lymphadenopathy, and interstitial lung di sease are common thoracic manifestations of SLE, whereas pleural abnor malities are less common than previously suggested. HRCT evidence of a irways disease and interstitial lung disease was frequently present de spite an absence of symptoms, a normal chest radiograph, and normal pu lmonary function testing, HRCT provides a sensitive and noninvasive te chnique for detecting pulmonary involvement in SLE, with the added adv antage that it can be performed in all patients, including those too c ompromised to undergo a surgical procedure. in patients with advanced disease, HRCT permits procedures such as bronchoalveolar lavage and lu ng biopsy to be directed toward areas of particular interest.