Diffuse Interstitial Lung Disease in Systemic Lupus Erythematosus

Eisenberg, Harvey; Dubois, Edmund L.; Sherwin, Russell P.; Balchum, Oscar J.

doi:10.7326/0003-4819-79-1-37

Cited by 177 publications

(55 citation statements)

References 12 publications

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“…In chronic interstitial pulmonary disease of SLE, histological reports describe nonspecific abnormalities with interstitial lymphocytic infiltrates, interstitial fibrosis and honeycomb changes [166,167]. The incidence of NSIP in SLE is not well defined [106].…”

Section: Lung Biopsymentioning

confidence: 99%

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Antoniou¹,

Margaritopoulos²,

Economidou³

et al. 2009

European Respiratory Journal

148

122

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The connective tissue disorders (CTDs), also called collagen vascular diseases (CVDs), represent a heterogeneous group of immunologically mediated inflammatory disorders with a large variety of affected organs. Individuals with a CTD (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, polymyositis/dermatomyositis and mixed connective tissue disease) are susceptible to respiratory involvement. When the lungs are affected, an increasing mortality and morbidity in CVDs occurs. Interstitial lung disease (ILD) is established as a clinical corollary across the spectrum of CTDs, with an overall incidence estimated at 15%.Therefore, pivotal clinical dilemmas remain in the evaluation and management of ILD involvement in CVDs. Critical questions are the presence of fibrosis and whether the disease is clinically significant. Moreover, the clinician has to decide if treatment is warranted and which is the best therapeutic approach. The use of additional tests, such as pulmonary function tests, high-resolution computed tomography scan, bronchoalveolar lavage fluid and surgical lung biopsy, deserves better discussion. The present review focuses on establishing the diagnosis of ILD in CTD, and on evaluating disease activity and prognosis. This will provide the basis for therapeutic decisions that will be discussed, including an overview of recent advances.

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Section: Lung Biopsymentioning

confidence: 99%

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Antoniou¹,

Margaritopoulos²,

Economidou³

et al. 2009

European Respiratory Journal

148

122

View full text Add to dashboard Cite

show abstract

“…ILD may also occur in SLE. However, the ILD in SLE is typically accompanied by other systemic disease manifestations and does not usually cause diagnostic problems [9,10,33,34].…”

Section: Ctd Mimicking Iip: Prevalence and Significance Of Early Diagmentioning

confidence: 99%

Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Tzelepis

Toya²,

Moutsopoulos³

2008

European Respiratory Journal

104

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“…Nonspecific pulmonary manifestations of lupus erythematosus have been described as interstitial fibrosis, chronic inflammatory changes, alveolar septa1 damage, and pulmonary vascular changes due to fibrinoid necrosis of small arteries and arterioles (8)(9)(10). Only isolated reports describing hematoxylin bodies in the lung parenchyma and alveoli are found in the literature (1 1,12).…”

Section: Discussionmentioning

confidence: 99%

Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma. Demonstration of the le phenomenon in the lung

Schleissner

Sheehan

Orselli

1976

Arthritis & Rheumatism

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A patient with systemic lupus erythematosus of long duration developed secondary amyloidosis and finally died after the additional complication of malignant lymphoproliferative disease. Multiple system involvement, typical serologic findings, and postmortem evidence substantiated the diagnosis of lupus erythematosus. Amyloid deposition was found in several organs, but was notably extensive in the adrenal cortex. This extensive deposition resulted in adrenal insufficiency, which was diagnosed clinically and treated until the patient's death from lymphoma. The particular nature of the malignant lymphoma is emphasized; a distinctive feature was the disappearance of positive lupus erythematosus cells from the buffy coat and the reduction in titers of relevant serologic tests toward the end of the illness. In spite of this reduction, many hematoxylin bodies and abundant complete lupus er- T h i s report describes a patient with long-standing systemic lupus erythematosus w h o developed adrenal insufficiency secondary t o amyloidosis. Several m o n t h s later t h e patient developed a n d died from complications of a n unusual malignant lymphoma. Postmortem examination demonstrated the presence of hematoxylin bodies and LE cells in t h e lungs. CASE REPORTThe patient was a 65-year-old Mexican male, admitted to the hospital for nausea, abdominal pain, weakness, and dizziness on February 8, 1970. The patient also complained of pain, stiffness, and swelling of his wrists, elbows, shoulders, and ankles. His history revealed periodic exacerbations and remissions also involving the metatarsal phalangeal joints and metacarpal phalangeal joints, neck stiffness, and pain and stiffness in the sacrolumbar region since 1962. In 1960 he was comatose for several days, but no specific diagnosis was made. There was no history of ingestion of procainamide, hydralazine, isoniazid, dilantin, phenothiazines, or other drugs that could be associated with the development of a lupus-like illness.Physical examination on admission in 1970 revealed a supine blood pressure of 120/60 mm Hg, pulse 72 and regular. On standing, the blood pressure dropped to 80/60 mm Hg and the pulse rose to 100. There was patchy scalp alopecia. The skin areas behind his ears, neck, and the creases of his arms and hands were hyperpigmented. Gynecomastia was noted.

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Diffuse Interstitial Lung Disease in Systemic Lupus Erythematosus

Cited by 177 publications

References 12 publications

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Occult connective tissue diseases mimicking idiopathic interstitial pneumonias

Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma. Demonstration of the le phenomenon in the lung

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