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Systemic Lupus Erythematosus and Lung Involvement: A Comprehensive Review
Jae Il Shin1, Keum Hwa Lee1, Seoyeon Park2
1Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Journal of Clinical Medicine
|November 26, 2022
Summary
Systemic lupus erythematosus (SLE) can affect the lungs, causing various pleuropulmonary conditions. This review details SLE
Area of Science:
- Rheumatology and Pulmonology
- Autoimmune Diseases
- Systemic Lupus Erythematosus (SLE)
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with frequent multiorgan involvement.
- Pleuropulmonary manifestations occur in 20-90% of SLE patients, yet their pathogenesis remains unclear.
- Key implicated factors include type 1 interferons, immune complexes, and neutrophils.
Purpose of the Study:
- To provide a comprehensive literature review on pleuropulmonary involvement in SLE.
- To summarize current knowledge on epidemiology, pathogenesis, diagnosis, and management.
- To highlight the diagnostic and therapeutic challenges in managing these conditions.
Main Methods:
- Literature review of existing studies on pleuropulmonary involvement in SLE.
- Analysis of diagnostic modalities including imaging (CXR, CT), PFTs, and invasive procedures.
- Review of therapeutic strategies, including immunosuppressants and targeted therapies like rituximab.
Main Results:
- Eight distinct types of pleuropulmonary involvement are identified in SLE.
- Diffuse alveolar hemorrhage (DAH) presents a high mortality rate (68-75%).
- Standard immunosuppressants (corticosteroids, cyclophosphamide) and rituximab show efficacy in specific manifestations.
Conclusions:
- Pleuropulmonary involvement is a significant and diverse complication of SLE.
- Early and accurate diagnosis using a combination of imaging and PFTs is crucial.
- Further research is needed to elucidate specific therapeutic approaches for these manifestations.
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