Pneumomediastinum in a 21-year-old Female with Lupus

Koczka, Charles; Otterbeck, Philip; Sharma, Vaibhav

doi:10.1097/smj.0b013e31818b692e

Cited by 5 publications

(4 citation statements)

References 2 publications

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“…Our patient did not have a pneumothorax, and the pneumomediastinum resolved completely in 5 days. Another patient with spontaneous pneumomediastinum but without idiopathic interstitial pneumonia has been described with SLE 8. These cases highlight a spectrum of presentations and varying prognosis of this condition.…”

Section: Discussionmentioning

confidence: 84%

Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus

Ahmed

Awouda²

2010

Case Reports

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SummaryWe report a case of a 29-year-old woman who is known to have systemic lupus erythematosus and idiopathic interstitial pneumonia; she presented with a 1-day history of substernal chest pain and increasing shortness of breath. On examination, she was found breathless, but was not distressed or afebrile or normotensive. Auscultation of the heart revealed a positive Hamman's sign. There was chest-wall crepitus, and auscultation of the lung showed bilateral crepitations. Full blood count and biochemical profile were unremarkable. Chest x-ray showed signs of idiopathic interstitial pneumonia in addition to pneumomediastinum (linear band of air within mediastinal planes and continuous diaphragm sign) and chest-wall subcutaneous emphysema. She was treated with high-concentration oxygen. A repeat chest x-ray 5 days later showed complete resolution of the pneumomediastinum and subcutaneous emphysema, but signs of idiopathic interstitial pneumonia continued to persist. BACKGROUND

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Section: Discussionmentioning

confidence: 84%

Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus

Ahmed

Awouda²

2010

Case Reports

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“…This was the first time that these rare complications were reported in a single patient. Pneumomediastinum in the absence of pneumothorax or ILD has also been described 11 . Two recent reports described resolution of subcutaneous emphysema, pneumothorax, and pneumomediastinum following treatment with broad-spectrum antibiotics and oxygen at high concentration 2,3 …”

Section: Discussionmentioning

confidence: 99%

“…Pneumomediastinum in the absence of pneumothorax or ILD has also been described. 11 Two recent reports described resolution of subcutaneous emphysema, pneumothorax, and pneumomediastinum following treatment with broad-spectrum antibiotics and oxygen at high concentration. 2,3 Pneumomediastinum is triggered by leakage of air through nonpartitional alveolar walls and subsequent dissection medially along the pulmonary vessels into the mediastinum.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Emphysema and Spontaneous Pneumomediastinum in Systemic Lupus Erythematosus and Dermatomyositis Overlap Syndrome

Vega-Villanueva

Berrocal-Kasay

2019

J Clin Rheumatol

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with a 5-day history of dry cough, persistent dyspnea on exertion, and mild anterior chest pain on inspiration. She developed liquid diarrhea 5 times daily, 3 days prior to admission. A syncopal episode occurred the day of admission. Medical history revealed an overlap syndrome diagnosed 3 months earlier, systemic lupus erythematosus (SLE) with Raynaud phenomenon, arthritis, malar rash, alopecia, renal and lung involvement (interstitial lung disease [ILD] with nonspecific interstitial pneumonitis pattern), and dermatomyositis (DM) with heliotrope, Gottron papules, Gottron sign with some ulcers (Fig. 1), severe proximal muscle weakness, anemia, lymphopenia, antinuclear antibody positivity at 1/80, anti-dsDNA at 172.3 IU, elevated creatine phosphokinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, aldolase, and proteinuria at 3.5 g/day. High-resolution computed tomography of the chest revealed diffuse FIGURE 1. Clinical features at diagnosis. A and B, Gottron sign with ulcers in elbows and knees. C, Cutaneous vasculopathy in palms. E, Gottron papules in metacarpal phalanges.

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“…case reports in lupus [8][9][10][11], rheumatoid arthritis [12], systemic sclerosis [13,14] and mixed connective tissue disease [15] exist. Here, we report four cases of pneumomediastinum: three of which are associated with dermatomyositis and one with mixed connective tissue disease.…”

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confidence: 99%

Pneumorrhachis and pneumomediastinum in connective tissue disease-related interstitial lung disease: case series from a tertiary care teaching hospital in South India

et al. 2011

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Pneumomediastinum has been described as a rare complication of connective tissue diseases. Here, we report four cases of pneumomediastinum: three of which are associated with dermatomyositis and one with mixed connective tissue disease. All our patients had interstitial lung disease. The first case of dermatomyositis described below was complicated by epidural emphysema (pneumorrhachis) in addition to pneumomediastinum. Pneumorrhachis is reported in many isolated case reports and series in the setting of asthma, pneumothorax, blunt chest trauma, etc. Less than 10% of pneumomediastinum cases develop this complication and vast majority of cases resolve spontaneously. The mechanism behind this has been postulated to be the passage of air through the intervertebral foramen. Others suggest entrapment of air which dissects between paraspinal soft tissues and along the vascular and nerve sheaths into the epidural space. This is the first ever reported case of epidural emphysema in connective tissue disease to the best of our knowledge.

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Pneumomediastinum in a 21-year-old Female with Lupus

Cited by 5 publications

References 2 publications

Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus

Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus

Subcutaneous Emphysema and Spontaneous Pneumomediastinum in Systemic Lupus Erythematosus and Dermatomyositis Overlap Syndrome

Pneumorrhachis and pneumomediastinum in connective tissue disease-related interstitial lung disease: case series from a tertiary care teaching hospital in South India

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