Respiratory tract disease in systemic lupus erythematosus

Respiratory tract involvement is common in adults with systemic lupus erythematosus (SLE). Although SLE in children usually follows a more severe course than in adults, there are few reports on pulmonary disease and lung function in children with SLE. We performed lung function tests and chest x ray examinations in eight children with SLE (mean age 11.1 years), three of whom presented with pulmonary symptoms. A high prevalence of lung involvement was found, including interstitial or localised infiltrations, pleural effusion, a restrictive impairment of lung function, and dysfunction of the diaphragm. Three patients required artificial ventilation. Two main mechanisms of ventilatory impairment seem to occur in children with SLE: firstly, acute interstitial pneumonia, which rapidly improves on treatment with steroids, and, secondly, restriction of lung volume, mainly due to respiratory muscle weakness.