Open lung biopsy in systemic lupus erythematosus patients with pulmonary disease

Open lung biopsy is an important diagnostic tool in immunocompromised patients with lung disease. This study evaluates the efficacy and safety of this procedure as part of the diagnostic work up in patients with Systemic Lupus Erythematosus (SLE) and lung disease. The casenotes of twelve SLE patients who had open lung biopsy were reviewed and the patients' clinical characteristics, laboratory investigations and outcome of the open lung biopsy were noted. Ten patients had bilateral reticulo-nodular opacities in the chest radiographic film while one had a persistent nodule in the right lower lobe and one had a normal chest X-ray. All the lung biopsy specimens had a diagnostic yield, e.g. interstitial pneumonitis, pneumonia, interstitial fibrosis and miliary tuberculosis. Three patients developed complications post-operatively, namely superimposed infection and pneumothorax. All responded to treatment. There were no deaths attributable to the surgical procedure. The high diagnostic yield and low morbidity in open lung biopsy support its use in the evaluation of pulmonary disease in SLE.