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Systemic lupus erythematosus

D Mulherin1, B Bresnihan

  • 1University College Dublin, St Vincent's Hospital, Dublin, Ireland.

Bailliere'S Clinical Rheumatology
|February 1, 1993
PubMed
Summary
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Systemic lupus erythematosus (SLE) frequently affects the lungs, causing pleuropulmonary issues in over half of patients. These lung complications, including pneumonitis and pulmonary hypertension, significantly impact SLE mortality and patient care.

Area of Science:

  • Rheumatology
  • Pulmonology
  • Internal Medicine

Background:

  • Systemic lupus erythematosus (SLE) is a prevalent connective tissue disease with widespread organ involvement.
  • Pleuropulmonary manifestations occur in over 50% of SLE cases, significantly impacting morbidity and mortality.
  • Pulmonary involvement ranges from common pleuritis to severe conditions like lupus pneumonitis and pulmonary hypertension.

Purpose of the Study:

  • To review the spectrum of pleuropulmonary manifestations in Systemic Lupus Erythematosus (SLE).
  • To highlight the clinical significance and management challenges of lung involvement in SLE.
  • To discuss the association of SLE with antiphospholipid syndrome and drug-induced lupus.

Main Methods:

  • Literature review of pleuropulmonary manifestations in Systemic Lupus Erythematosus.

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  • Analysis of clinical presentations, diagnostic challenges, and therapeutic implications.
  • Examination of specific conditions including pleuritis, lupus pneumonitis, pulmonary hypertension, and pulmonary embolism.

    • Main Results:

    • Pleuritis is the most common manifestation, though rarely life-threatening.
    • Acute lupus pneumonitis, chronic lupus pneumonitis, and pulmonary hypertension are serious complications contributing to SLE mortality.
    • Pulmonary sepsis is a major cause of death in immunocompromised SLE patients.
    • Drug-induced SLE can present with pleuritis, and associations with sarcoidosis and asbestosis are noted.

    Conclusions:

    • Pleuropulmonary involvement is a critical and frequent feature of Systemic Lupus Erythematosus.
    • Early recognition and management of lung manifestations are essential for improving outcomes in SLE patients.
    • Understanding the diverse pulmonary complications is vital for comprehensive SLE patient care.