Interstitial lung disease in systemic lupus erythematosus

Abstract

Systemic lupus erythematosis (SLE) is a heterogenous disease of unknown etiology. It is not uncommon to see pleuropulmonary involvement in isolation or along with the involvement of other organ systems in SLE. Pulmonary manifestations of SLE can involve the pleura, lung parenchyma, airways, pulmonary vasculature, and the respiratory muscles. In this review we discuss two important pulmonary manifestations of SLE: acute lupus pneumonitis and diffuse interstitial lung disease. These two conditions have a major impact on the mortality and morbidity of patients with SLE and it is essential to recognize and treat them appropriately. High-resolution computed tomographic scans of the chest and pulmonary function tests help to establish a diagnosis and aid long-term follow-up of these patients. High-dose corticosteroids are the mainstay of treatment for the two conditions, although other agents such as cyclophosphamide, azathioprine, intravenous gamma globulin, and plasmapheresis have been used with varying degrees of success.

Pulmonary Manifestations of Systemic Lupus Erythematosus

“…(Boulware & Hedgpeth, 1989) A more recent review confirmed this association (Mochizuki et al, 1999) The high frequency of anti-Ro/SSa antibodies raises the possibility of their role in the pathogenesis of ALP. (Cheema & Quismorio, 2000) Prognosis is poor, with mortality reaching up to 50% as reported in an old study. (Matthay et al, 1975) The outcome is worse if ALP occurs postpartum.…”

“…Pulmonary fibrosis affects 18% of patients above 50 years compared to 2% of patients under 18 years. (Cheema & Quismorio, 2000) Clinically, patients usually present with gradually progressive shortness of breath. Chronic dry cough can be the initial presentation in some patients.…”

A szisztémás lupus erythematosus pulmonalis manifesztációi

“…Kezelésében a nagy dózisú kortikoszteroid adását javasolják, amelynek dózisa 1-2 mg/kg/nap. Súlyos és szteroidrezisztens esetekben javasolható azathioprin-, cyclophosphamid-, IVIG-kezelés és plazmaferézis monoterápiában, illetve sikertelenség esetén kombinálva [33][34][35].…”

“…Az SLE-asszociált ILD megjelenése általában az idősebb, férfi betegekben gyakoribb [35]. Diffúz ILD vagy krónikus pneumonitis a betegek 3-8%-ánál fordul elő [36].…”

Recent‐onset systemic lupus erythematosus complicated by acute respiratory failure

“…Given the patient's multiorgan inflammation attributable to SLE, acute lupus pneumonitis was considered; however, acute lupus pneumonitis is an uncommon manifestation of SLE (6). It is typically a diagnosis of exclusion that is considered as the cause of hypoxia in SLE only after infectious and other etiologies have been excluded.…”