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Srpski arhiv za celokupno lekarstvo 2020 Volume 148, Issue 9-10, Pages: 535-540
https://doi.org/10.2298/SARH190730061S
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Pleuropulmonary manifestations of systemic autoimmune diseases: An 84-case series analysis

Stević Ruža ORCID iD icon (Center of radiology and MRI, Clinical center of Serbia, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia), ruzastevic@yahoo.com
Nagorni-Obradović Ljudmila (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinic for pulmonology, Clinical Centre of Serbia, Belgrade, Serbia)
Pešut Dragica ORCID iD icon (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinic for pulmonology, Clinical Centre of Serbia, Belgrade, Serbia)
Škodrić-Trifunović Vesna (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinic for pulmonology, Clinical Centre of Serbia, Belgrade, Serbia)
Čolić Nikola ORCID iD icon (Center of radiology and MRI, Clinical center of Serbia, Belgrade, Serbia)
Jovanović Dragana (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinic for pulmonology, Clinical Centre of Serbia, Belgrade, Serbia)

Introduction. The systemic autoimmune diseases (SAD) can cause a variety of pulmonary and pleural abnormalities. The aim of this paper is to review clinical and radiological characteristics of a series of patients with a systemic autoimmune disease hospitalized at a tertiary level facility. Methods. In this retrospective study, we reviewed the clinical and imaging findings in patients diagnosed with SAD at the Teaching Hospital of Pulmonology during a nine-year period. Results. An 84-patient group (mean age of 53.8 years) consisted of 64 women and 20 men. Fifty-eight out of 84 patients suffered from collagen vascular disease (CVD) and 26/84 had systemic vasculitis. Fatigue was the dominant symptom (75.8% in CVD, and 69.2% in vasculitis). Cough, hemoptysis, and fever were more frequent in patients with vasculitis. Fibrosis was the most common radiological manifestation of CVD (26/58), followed by pleural effusion (18/58) and consolidation (10/58). Irregular opacities were dominant radiologic finding in vasculitis (10/26), followed by nodules (8/26). Histological confirmation of systemic autoimmune disease was obtained in 28.6% patients, in 58/84 patients the diagnosis was based on a positive serologic test and clinico-radiological manifestations, in two cases on clinical and radiological features according to defined criteria. Conclusion. Pleuropulmonary manifestations of SAD are usually expressed in the sixth decade of life, predominantly in women. Clinical findings and positive serologic tests suggest diagnosis of SAD. Fibrosis is the most common radiologic pattern found in almost one half of the patients with CVD and irregular opacities are the most common findings in vasculitis.

Keywords: autoimmune diseases, vasculitis, pleura, pulmonary, radiology

Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175046