Pleuropulmonary involvement in patients with collagen vascular diseases

Background
Collagen vascular diseases are a diverse set of autoimmune disorders that can affect any part of the pulmonary system.


Purpose
This study aimed to identify the frequency, severity, pattern, and outcome of pleuropulmonary involvement in collagen vascular diseases among a cohort of Egyptian population.


Patients and methods
This cross-sectional study was carried out on 50 cases, who were diagnosed as collagen vascular disease (fulfilling the published classification criteria for each disease) and developed respiratory symptoms. The included cases were subjected to detailed history, clinical examination, and investigations included mainly chest imaging (high-resolution computed tomography for all cases, chest ultrasound, and computed tomography pulmonary angiography when needed), pulmonary functions tests, and echo. Follow-up of patients was done at the end of hospital stay and at 1 month after discharge.


Results
The mean age of the studied population was 44.34 ± 14.22 years with female predominance representing 74% of cases. The most common diagnosed collagen vascular disease was rheumatoid arthritis in 42% of cases, followed by systemic lupus in 38% of the cases. Dyspnea was the most common presenting symptom among the studied patients in 70% of cases. Parenchymal involvement was the most common involvement among 86% of the cases followed by pulmonary vascular involvement in 62% of the cases. The outcome among the included patients was improvement in 54% of cases, partial improvement in 20% of cases, stationary in 20% of cases, and 6% of included cases died at the end of hospital stay.


Conclusion
Parenchymal involvement and pulmonary hypertension were, respectively, the most pleuropulmonary involvement in collagen vascular diseases among a cohort of Egyptian population. Mortality rate was higher among systemic lupus patients in activity with other parenchymal involvement group and interstitial lung disease.