Prevalence of Pulmonary Embolism Among Systemic Lupus Erythematosus Discharges

Annangi, Srinadh; Dammalapati, Tirumala Rao; Nutalapati, Snigdha; King, Marshaleen N. Henriques

doi:10.1097/rhu.0000000000000521

Cited by 11 publications

(12 citation statements)

References 37 publications

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“…These alterations were present in 40% of patients with SLE, pleural effusion being the most frequent cause of ARI, which is consistent with the data reported in other studies . The prevalence found for pneumonia (16.5% vs 21%), pulmonary hemorrhage (2.5% vs 1.6%‐2%) and pulmonary thromboembolism (3% vs 1.62%‐2.22%) were similar to those of other latitudes; however, the frequency of lupus pneumonitis was higher in the Colombian population compared to other studies (9% vs 4%‐5.3%) …”

Section: Discussionsupporting

confidence: 90%

“…Regarding the other comorbidities, in our study it was determined that the presence of antiphospholipid syndrome predisposes to the presence of ARI. In similar studies, this association has been established, especially with the presence of pulmonary thromboembolism . One important finding of the present study is the presence of pericardial disease as a marker of ARI, since a statistically significant association was found in both the bivariate and multivariate analyses, which has not been reported in other studies until now, thus identifying a risk factor of significant value in patients with SLE.…”

Section: Discussionsupporting

confidence: 74%

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Acute respiratory involvement in Colombian patients with systemic lupus erythematosus undergoing chest computed tomography

et al. 2019

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Introduction Systemic lupus erythematosus (SLE) is an inflammatory disease which affects multiple organs. The respiratory system is compromised in 1.6% to 36% of the patients with SLE. The objective of this study was to know the prevalence of these alterations, their associated variables, and outcomes in patients with SLE between 2012 and 2017. Methods A cross‐sectional study of 200 patients with SLE underwent chest computed tomography (CT). The primary outcome was acute respiratory involvement (ARI). A descriptive, bivariate and multivariate analysis were performed using Stata 12.0 software. Results ARI was present in 40% of the SLE patients undergoing chest CT. The most frequent ARI was pleural effusion in 33%, followed by pneumonia (16.5%), lupus pneumonitis (9%), pulmonary embolism (3%) and pulmonary hemorrhage (2.5%). In bivariate and multivariate analysis a statistically significant association between ARI and nephropathy, hematological impairment, active disease, dead, readmission and prolonged hospital stay was found. Conclusion This is the first Colombian study that evaluates ARI in patients with SLE. ARI is an important and frequent condition in patients with SLE, pleural effusion being the most prevalent cause of ARI. There are some variables (nephropathy, hematological impairment and activity disease) that are associated with ARI and could be the basis of intervention.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 74%

Acute respiratory involvement in Colombian patients with systemic lupus erythematosus undergoing chest computed tomography

et al. 2019

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“…In the present study, heparin was used in 13% and warfarin in 5% of our population. Anticoagulation therapy is well-known for its usage in life threatening preventable medical condition involving sudden occlusion of arteries [1,56]. SLE predisposes patients to both arterial and/or venous thrombosis and may occur in almost 20% of patients [57].…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary hypertension in association with SLE may be primary or secondary to TE events and antiphospholipid syndrome, its often severe and progressive even in association with minimal disease activity and requires long-term anticoagulation therapy [59]. Anti-phospholipids condition improves with anticoagulants, corticosteroid therapy and the addition of hydroxychloroquine [1,56,60,61]. Combination of SLE and thromboembolism has a more negative influence on reported health related quality of life, compared to having SLE or APS alone [62].…”

Section: Resultsmentioning

confidence: 99%

“…Combination of SLE and thromboembolism has a more negative influence on reported health related quality of life, compared to having SLE or APS alone [62]. Patients with APS should receive anticoagulation +/-low-dose aspirin [1,56,60,61] however in patients with APL there are conflicting data and variation in clinical practice in treatment worldwide and there are many factors to be considered . In the present study, aspirin was utilized by 21%, comparable to the findings reported in European literature [57].…”

Section: Resultsmentioning

confidence: 99%

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2018

J Rheum Dis Treat

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Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that has various manifestations among different populations. This study aims to provide an overview of medical pharmacological management that SLE population received immediately at time of diagnosis. Method: This is a retrospective analysis using patients' registry medical information system. All patients diagnosed with SLE were reviewed by accessing their medical records including pharmacy prescription and dispersions at the Royal hospital from 2006 to 2014. The following comorbidities were analyzed: diabetes mellitus (DM), hypertension (HTN), hyperlipidemia, lung disease, cardiovascular disease (CVD), cerebrovascular accident (CVA), chronic kidney disease (CKD), end-stage kidney disease (ESKD), infections, thyroid disease, malignancy, and miscarriages. Results: There were 966 patients diagnosed with SLE during the period from 2006 to 2014. The Mean (SD) of age at presentation was 35.5 (11.5) years. Most patients were female (88.7%) with mean age of 27.6 (1.4) years. Unsurprisingly anti-malarial drug, hydroxychloroquine was used in 95% of SLE patients and steroid therapy was used in 93% in which 60.95% received Methylprednisolone pulse. The immunosuppressive agent of choice was Cyclophosphamide in 25.04%. Mycophenolic acid (MPA) medication in 39.85% and azathioprine in 37.06% of patients. Anti CD20 monoclonal antibodies, rituximab, was used in 20.91%. Calcineurin inhibitors were used in total of 11% of patients (cyclosporin a in 6.72% and tacrolimus in 4.35%). Conclusion: The complexity of SLE presentation have led to diverse pharmacotherapeutic strategies based on the organ systems involved. Management is individualized and depends on presenting symptoms and reducing the likelihood of permanent damage to organs and tissues. Strengthen health system at primary level and education of public and health work force is the main challenge to further improve the management. The overall aim of management was to determine the extent of disease and prevent extensive organ involvement and deal with various traditional and non-traditional CVD risk factors. The involvement of clinical pharmacist is very important to further strengthen the pharmacological management of lupus patients.

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