CT Findings of Pulmonary Involvement in Antiphospholipid Syndrome.
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Date
2013-10
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Abstract
Aims: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder
characterized by vascular thrombosis. Pulmonary changes regarding interstitium and airways have not been described in APS. Our aim was to determine the prevalence of
nonthrombotic pulmonary CT manifestations in patients with APS.
Study Design: Prospective study.
Place and Duration of Study: Department of Pneumonology, First Department of
Internal Medicine, Department of Cardiology, Department of Radiology Medicine,
between June 2009 and May 2011.
Methodology: Ten patients who met criteria for APS (5 primary and 5 secondary to
systemic lupus erythematosus) were prospectively identified. All patients underwent
chest high-resolution computed tomography (HRCT) and functional assessment
including spirometry and 6-minute walking distance. Patients were free of respiratory
symptoms. HRCT scans were evaluated for presence of air-trapping, subpleural reticular
pattern, centrilobular nodules of ground-glass opacity, cysts, emphysema, atelectasis,
consolidation and pleural effusion. Extent of air-trapping was estimated based on a
HRCT scoring system.
Results: All patients exhibited radiological and functional pattern compatible with smallairway
disease, irrespective of smoking status. HRCT findings were negatively correlated
with reduced levels of maximum midexepiratory flow (MMEF) 25/75%pred (r=-0.936,
p<0.0001). Subpleural basal reticular pattern consistent with fibrosis was seen in 3
patients. Thin-walled cysts and upper-lobe hazy micronodular pattern were detected in 4
patients.
Conclusion: CT findings of patients with APS may include air-trapping, subpleural
reticular pattern, centrilobular nodules of ground-glass opacity and lung cysts
irrespective of smoking history and SLE coexistence. HRCT and functional assessment
may be valuable tools in evaluating APS patients.
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Keywords
Antiphospholipid syndrome, lung, HRCT, small airway, interstitial lung disease
Citation
Tzouvelekis Argyris, Skendros Panagiotis, Prassopoulos Panagiotis, Mitroulis Ioannis, Apostolidou Eirini, Thomaidi Adina, Ritis Konstantinos, Bouros Demosthenes, Oikonomou Anastasia. CT Findings of Pulmonary Involvement in Antiphospholipid Syndrome. British Journal of Medicine and Medical Research. 2013 Oct-Dec; 3(4): 855-867.