Severe cognitive dysfunction and shrinking lung syndrome in systemic lupus erythematous

Area of Science:

• Rheumatology
• Neurology
• Pulmonology

Background:

• Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease.
• Neuropsychiatric and pulmonary involvement affect 40% and 50% of patients, respectively.
• Common manifestations include cognitive impairment, seizures, pleurisy, and pneumonitis.

Observation:

• A 49-year-old woman presented with rapidly progressive cognitive impairment and respiratory failure.
• These symptoms were attributed to shrinking lung syndrome, a rare SLE manifestation.
• This case highlights the potential for rare pulmonary complications to be the initial presentation of SLE.

Findings:

• The patient experienced severe cognitive impairment linked to respiratory failure from shrinking lung syndrome.
• This association underscores the under-diagnosis of lupus pulmonary complications.
• Prompt recognition and treatment are vital for managing severe SLE manifestations.

Implications:

• Increased awareness of rare pulmonary manifestations in SLE is needed.
• Early diagnosis of lupus pulmonary complications can prevent severe neurological sequelae.
• Aggressive treatment strategies may be required for patients with severe SLE involvement.