Chest X-ray Abnormalities of Patients with Systemic Lupus Erythematosus Presenting with Cough and its Association with Disease Activity

Abstract

Objective: To assess the pattern of chest x-ray abnormalities and their relationships with disease activity in systemic lupus erythematosus (SLE) patients with cough. Methods: This cross-sectional study was conducted at Bangladesh Medical University’s Department of Rheumatology, Dhaka, Bangladesh. Patients with SLE who reported cough of any duration were enrolled using the 2019 American College of Rheumatology/ European League Against Rheumatism classification criteria. Clinical history, physical examination findings, chest x-ray, relevant lab tests and the SELENASLEDAI score were documented. Subjects were divided into groups based on the presence of chest x-ray abnormality. Multiple logistic regression (backward elimination) was used to identify the factors associated with chest x-ray abnormalities. Results: Eighty cases (74 females and 6 males) with a mean age of 29.2 were recruited. Forty patients had abnormalities in their chest X-rays. Common X-ray abnormalities were cardiomegaly (35%), pleural effusion (27.5%), consolidation (15%), inhomogeneous opacities (22%), reticulonodular shadows (17.5%), pulmonary cavitary lesion (5%) and miliary mottling (2.5%). Shortness of breath, abnormal breath sounds and added sounds were also more marked in these patients. In contrast, those with normal X-ray chest (n=40) had signs and symptoms of upper respiratory tract inflammations only. X-ray abnormalities were associated with low body mass index, increased anti-double-stranded DNA, erythrocyte sedimentation rate, Creactive protein, low hemoglobin and lymphopenia (all P <0.05). X-ray abnormalities were independently associated with a high disease activity score and a high erythrocyte sedimentation rate. Conclusions: Conventional chest x-ray abnormalities were associated with higher disease activity among patients with SLE presenting with cough.

J MEDICINE 2026; 27: 78-85